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PUBLIC WORKS Data <br /> Public Works Permit a <br /> PERMIT Building Permit N <br /> PUBLIC WORKS DEPARTMENT Planning Reference N <br /> 3200 Cedar Street <br /> Everett,WA 98201 Pudic Works Fee$ <br /> (425)257.8810 - <br /> 1 I 1 N07R 2 4 ..7 Guarantee$ <br /> OWNER NAME w r� APPLICANT NAME <br /> ANDADDRESS AC-IR F.NTF.RFRTSF.S 1.1.0 AND ADDRESS: <br /> 351h AVE SE <br /> B0711ELL WA 980E <br /> PHONE: PHOI <br /> 425749171E <br /> TAX PARCEL 1.0.0 PACUECTADDRESS: <br /> DESCRIPTION OF <br /> PROPOSED WORK: 11E4t lir>USE - BASIC 17L <br /> PERMIT CONDITIONS ;fl' 1-7 ?'...: <br /> 1. All calls for Inspection shall be made 24 hours in advance. <br /> 2. All work shall be performed In accordance with this permit and current City of Everett Design and Construction <br /> Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1.800.424.5555 W <br /> laaaaa <br /> 4. Connect aide sewer per City >tandard 501,602, 6-.04, <br /> S. Connect rooftop downspouts to the side sever. <br /> 6. Install rrrosion conttol measures per C1Ly of Everett. Standards for small paq4 el,lgl' <br /> 7. Remove erosion r—mtrol me•amuren upon completion of the pro}C2 Y ktY2Y 1b`2iru Cl? <br /> approval of the permit. <br /> 8. No dirt, mud, rw:ks or debris to Lw tracked on to ro3dv g <br /> 9. li,� huiLiTluf m<;t=•r;r+la to be st;rr-•ked r,n sidewalks and 9 ewaWnt to h.• kept CSan ati <br /> open for pede-ittian travel. J <br /> 10. lave 'tivevay from the frc•nt property line out to the stf#et paving. Q �` Z <br /> Y4UF: 11151,ECT.OI. IS 1':r+NDY ALLAN 425-'x99-7403 � <br /> " O <br /> 4r r u r <br /> �l]t88888�� O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and <br /> � `T /" 7 ZC' �•` save harmless the City of Everett from any and all claims for <br /> / <br /> M r Conalructlon 1Date damages,costs,expenses,or causes of action that may arise <br /> because of installation and maintenance of the improvement or <br /> 7 O other right-of-way use hereto applied for and further agrees to <br /> remove same upon notice from the City and to replace public <br /> FINAL INSPECJON Iproperly damaged thereby. <br /> Approved as CxImiflucted Data <br /> t \ <br /> Signature AppacaM Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED <br /> .� TO COMPLETION,THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br /> Epwp gM61 DATABAR.INC. <br />