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PUBLIC WORKS PERMIT Date: 11/7/2013 <br /> Public Works Permit#: PW1311-005 <br /> City of Everett Public Works Department <br /> 3200 Cedar Street Building Permit#; <br /> Everett, WA 98201 Planning Reference#: <br /> (425) 257-8810 <br /> Public Works Fee$: $ 300.00 <br /> Other$: <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> JIM AUSTIN CCS, ADISION OF PNE CORP. <br /> 1345-183rd AVE NE 9420 NW ST HELENS RD <br /> BELLEVUE WA 98008 PORTLAND OR 97231 <br /> PHONE: 2064092560 PHONE: 5032479466 <br /> TAX PARCEL ID# SITE ADDRESS: 8630 EVEREGREEN WAY <br /> DESCRIPTION OF PROPOSED WORK: <br /> REMOVE CONTAMINATED SOIL <br /> (11/7/2013 2:28 PM BES) <br /> REMOVE CONTAMINATED SOIL AND BACKFILL. <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 �y <br /> T 4d 1 F-.7"i <br /> 4. Install eroision control per City of Everett Standards. ' <br /> 5. Remove eroision controlmeasures upon completion of the project prior to final approval of the permit. w <br /> 6. No dirt, mud, rocks or debris to tracted into the roadway. n F4 z <br /> 7. Dispose the contaminated soil to an approved site. C-11C' 7-c' N <br /> 8. The contractor must meet with the City of Everett inspector Cliff Lindman 425-339-7404 prior to s�f�rting � ~ <br /> construction. r,,, . <br /> mar <br /> a r a <br /> G `s C7 ''• i T/1 <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and <br /> save harmless the City of Everett from any and all claims for <br /> damages, costs,expenses, or causes of action that may arise <br /> because of installation and maintenance of the improvement <br /> c?� u' or other right-of-way use hereto applied for and further agrees <br /> roved for Constru io Date to remove same upon notice from the City and to replace <br /> p pub is property damaged thereby. <br /> cL 13 <br /> FINAL INSPECTION Date <br /> Approved as Constructed Sign r of A • nt 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 />