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PUBLIC WORKS PERMIT Date: 11 016 <br /> Public Works Permit#: PW1611-034 <br /> City of Everett Public Works Department <br /> -`' 3200 Cedar Street Parent Permit#: C1611-012 <br /> Everett, WA 98201 <br /> Planning Reference#: SUB14-002 <br /> (425) 257-8810 <br /> Public Works Fee$: $ 919.00 <br /> Other $: <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> POLYGON WLH LLC PANI ALAN / POLYGON <br /> 4695 MACARTHUR CT 8TH FLR <br /> NEWPORT BEACH CA 92660 <br /> PHONE: PHONE: 4255867700 <br /> TAX PARCEL ID# 29053200102300 SITE ADDRESS: 4412 30TH DR SE LOT 33 <br /> SITE WORK AND TRAFFIC MITIGATION FOR NEW SFR <br /> LOT 33 OF THE PLAT OF OVERLOOK AT RIVERFRONT DIV 1 <br /> Section 32 Township 29 Range 05 <br /> Quarter NE NEW LOT 13 OF COE <br /> BLA#08-004 REC LINDAFN <br /> ?00804080781 & ROS 200804085006 & <br /> PERMIT CONDITIONS AS CORR BY AFN 201206070611 <br /> 1. All calls for inspection shall be made 24 hours in advance. BEING A PTN OF GOVT LOTS 2, 3 & 6 <br /> 2. All work shall be performed in accordance with the permit and current City of Everett Design and Construction Std"ps <br /> and Specifications. <br /> 3. Call Location Underground Service 48 hrs before you dig. TOLL FREE NUMBER 811 <br /> 4. No dirt, mud, rocks, or debris to be tracked onto roadway. w <br /> 5. Contact the City of Everett Public Works Inspector Randy Allen at 425-339-7403 prior <br /> to starting construction and with other inspection requests. [�I <br /> 6. Install any erosion control measures as determined by the Public Works Inspector, <br /> such as silt fence, straw bales, swales, or erosion blankets. <br /> 7. Connect side sewer per City Standard #'s 601 through 604. <br /> 8. Connect rooftop downspouts to the drainage system provided for this lot. O <br /> 9. No building materials to be stacked on sidewalk/roadway and sidewalk/roadway to be <br /> kept clean and open for pedestrian travel. <br /> 10. Public Works Construction Shall be done per approved plan dated 11/23/2016. (copy <br /> attached) <br /> Public Works Permit Fee Breakdown: <br /> PW Plan Review..............$20.00 <br /> PW Site Inspection..........$20.00 DEC - 1 2016 O <br /> Driveway..........................$25.00 a <br /> Traffic Mitigation ...........$854.00 CITY OF EVERETT <br /> Permit Services <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 /> A roved for Construction Date improvement or other right-of-way use hereto applied for and further agrees to <br /> pp remove same upon notice from the City and to replace public property <br /> damaged thereby. <br /> FINAL INSPECTION Date �;>✓1�1� <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 /> `� w <br />