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PUBLIC OORKS PERMIT Date: 3/21/2016 <br /> Ir Public Works Permit#: PW1603-048 <br /> City of Everett Public Works Department <br /> 3200 Cedar Street Parent Permit#: <br /> Everett, WA 98201 <br /> (425) 257-8810 Planning Reference#: <br /> Public Works Fee $: $ 65.00 <br /> Other $: <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> LOPEZ-BAEZ CARLOS <br /> 2901 BUTLER ST <br /> EVERETT WA 98201-1267 <br /> PHONE: 2068542221 PHONE: <br /> TAX PARCEL ID# 00396600008400 SITE ADDRESS: 2901 BUTLER ST <br /> RELOCATE DRIVEWAY AND PAVE BACKYARD <br /> BRIDGEWAY BLK 000 D-00 - LOT 84 <br /> TGW E 1 OFT VAC HAWTHORNE ST <br /> ABTG PER ORD 3246 REC <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. Site Civil Work to be done per plans approved by the City of Everett Public Works <br /> Department dated 3/21/2016. "+ w <br /> 5. Contact the City of Everett Public Works Inspector Randy Allen at 425-339-7403 prior �� <br /> J'} <br /> to starting construction and with other inspection requests. <br /> 6. Install erosion control measures per City of Everett Standards for small parcels or as f" 11-0� <br /> directed by the Public Works Inspector, and remove upon completion of the project prior <br /> to final approval of the permit. ; I. <br /> 7. Keep City streets clean at all times. No dirt, mud, rocks, or debris to be tracked onto O <br /> roadway. t <br /> 8. Protect existing underground utilities. <br /> 9. Pave driveway to edge of paved road. i�Tl - Z <br /> ut 8 .rF at+ <br /> 10. Drivewaywidth shall be no greater than 20ft. <br /> 9 <br /> 11. Slope driveway towards vegetated surfaces and keep all runoff from new impervious <br /> surfaces on-site. I <br /> -� V1 <br /> Public Works Permit Fee Breakdown: O <br /> Paving (Driveway)......................................$45.00 <br /> PW Site Inspection....................................$20.00 <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 /> OZO�b 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 /> Approved for Construction Date remove same upon notice fr m the ity and to replace public property <br /> damaged thereby. <br /> D <br /> FINAL INSPECTION Date -- `— <br /> Approved as Constructed Signature 0-f-0 n 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 /> iI �'C' <br />