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PUBLIC WORKS PEI�MIT Date: 3/13/2015 <br /> Public Works Permit#: PW1503-013� <br /> City of Everett Public Works Department <br /> � �,� 3200 Cedar Street Building Permit#; C1502-012 <br /> Everett, WA 98201 Planning Reference#: <br /> (425) 257-8810 ' <br /> Public Works Fee $: $ 65.00 <br /> Other $: <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> BELMARK <br /> 4229 76TH ST NE#105 <br /> MARYSVILLE Wq 98270 <br /> PHONE: 3606533634 PHONE: <br /> TAX PARCEL ID# 00571700400400 SITE ADDRESS: 5109 SOUND AVE <br /> DESCRIPTION OF PROPOSED WORK: <br /> PUBLIC WORKS FOR NEW HOUSE <br /> SS 1202-2014-006 <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. Connect side sewer per City Standard #'s 601, 602, 604. <br /> ss the storm w <br /> ater system prior to beginr�i�g ;'-; w <br /> heTho e�t tCall RandStAllen a 1425 339ub403. orks Ins ector to�discc ,I <br /> p u <br /> P 1 Y <br /> 6. Remove erosion control measures upon completion of the pr 1�_t prior�to fi�tal �pproval;of th�.:perrn�t: _;._ �"� <br /> ,: _ ►-� <br /> 7. No dirt, mud, rocks or debris to be tracked onto roadway. ' ` <br /> _.. <br /> - �_ <br /> _ ,,. _- ,, , <br /> ; � � � � <br /> , ; : ... �-� <br /> ,.,-.... ,..._..; ,_:r, <br /> __ _;;� - � <br /> ;=: �` <br /> �•�.�! <br /> ,�6 r .� <br /> 1� �' � <br /> �1n�� O <br /> �:j�.i�j-h 'FJ'4 st <br /> � ,r..`_� �A.d ^..:� <br /> 1 '�d�i.> i_.�, i_._• • .r.+F r.r:r ir:F'� � <br /> �I1� I 1 ��I ��_A'i*1.i'`1.lf;h't:;F.:7c•'CJY '�.L!i'`.:)1_..:I h��._-7•i,tir <br /> TQ PQ����G _ �r�-�r_�i-�� ti �� r-�r d �;rl q.. Y!a <br /> �I c �;��i ��, .r.:..�_..., � .�, � � <br /> � '�„�7�_.. �r.'; �_:a o-�� .._� .-- �— '1�'�'... O <br /> .�1 b .__ .. i.... .,_ -;. ..�. ._ ..�. <br /> � <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and <br /> save harmless the City of Everett from any and ali claims for <br /> ,'" damages, costs, expenses, or causes of action that may arise <br /> � � - because of installation and maintenance of the improvement <br /> ,� '�: �{, i � , `�' _ , � � "t ,;, 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 /> App ve f Con )r� 7 Date public property damaged thereby. <br /> = - � /� � � <br /> C��"�- �- �-/.� f � ;�n� �-; - �r <br /> FINAL INS . CTION Date <br /> �� �� � > � �� <br /> Approved as Constructed 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 /> I V� <br />