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PUBLIC WORKS PERMIT Date: 4/19/2016 <br /> City of Everett Public Works Department Public Works Permit#: PW1604-042 <br /> M <br /> 3200 Cedar Street Parent Permit#: <br /> Everett, WA 98201 Planning Reference#: <br /> (425) 257-8810 <br /> Public Works Fee $: $ 25.00 <br /> Other $: <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> GOLDWYN BILL UNITED GENERAL CONTRACTORS <br /> 5908 LARIMER RD BRYAN FOSMARK <br /> EVERETT WA 98208 <br /> PHONE: PHONE: 4255307552 <br /> TAX PARCEL ID# SITE ADDRESS: 5908 LARIMER RD <br /> WORK WITHIN ROW TO CLEAR DISCHARGE AREA FOR YARD DRAINAGE <br /> PERMIT CONDITIONS <br /> 1. All calls for inspection shall be made 24 hours in advance. <br /> 2. All work shall be performed in accordance with the permit and current City of Everett Design and Construction Standards <br /> and Specifications. <br /> 3. Call Location Underground Service 48 hrs before you dig. TOLL FREE NUMBER 811 <br /> 4. The contractor must meet with the Public Works Inspector to discuss potential <br /> drainage routing prior to beginning the project. Call Randy Allen at 425-339-7403. r= w <br /> 5. Install erosion control measures as determined by the Public Works Inspector, such 00 <br /> as silt fence, straw bales, swales, or erosion blankets. �° T <br /> r•.:3 m <br /> 6. Provide any necessary traffic control as indicated by the puplic works inspector and <br /> the MUTCD. V4 <br /> Public Works Permit Fee Breakdown: <br /> Misc minor permit $25.00 r.' ``3 <br /> "-"T41P:, <br /> r4 <br /> C.JJ <br /> 1 <br /> {A®y <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harmless the <br /> City of Everett from any and all claims for damages, costs,expenses,or <br /> causes of action that may arise because of installation and maintenance of the <br /> improvement or other right-of-way use hereto applied for and further agrees to <br /> )INAL <br /> eINSPOCTION <br /> r on do Date remove same upon notice from the City and to replace public property <br /> �� damaged thereb <br /> Date L/ Z e- /b <br /> Approved as Constructed ,Signa �plicant Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY <br /> PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />