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PUBLIC WORKS PERMIT Date: 11/14/2012 <br /> Public Works Permit#: PW1211-010 <br /> City of Everett Public Works Department <br /> 3200 Cedar Street Building Permit#; CW1210-006 <br /> Everett, WA 98201 <br /> (425) 257-8810 Planning Reference#: <br /> Public Works Fee $: $ 25.00 <br /> Other $: <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> BROWNFIELD KEITH W& DEBBIE A <br /> 22021 SE 29TH PL <br /> SAMMAMISH WA 98075 <br /> PHONE: 2067148440 PHONE: <br /> TAX PARCEL ID# 00562456301200 SITE ADDRESS: 2523 WETMORE AVE#AB <br /> DESCRIPTION OF PROPOSED WORK: <br /> DRIVEWAY-SFR TO DUPLEX CONVERSION <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. Water and sewer may need to be upgraded to a larger size to service a duplex. <br /> Your Public Works Inspector is Randy Allen. Call him at 425-339-7403 for questions and inspections; <br /> _.aj <br /> �7 <br /> /O <br /> h'r'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 /> or other right-of-way use hereto applied for and further agrees <br /> to remove same upon notice from the City and to replace <br /> Appro r Construc Date <br /> public property damaged thereby. <br /> �j <br /> KNAL NSPE 1 Date <br /> Approved as Uonstructed Signature of Applicant 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 />