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PUBLIC�VORKS PERMIT � � ��� ���� <br /> � Date Applied: 6/26/2017 <br /> City of Everett Public Works Department Public Works Permit#: PW1706-046 <br /> 3200 Cedar Street Parent Permit#: <br /> Everett,WA 98201 Planning Reference#: <br /> ���'--�'•�����l -� (425) 257-8810 Public Works Fee: $65 <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> RUSSELL ADAM RUSSELL ADAM <br /> 2119 E GRAND AVE 2119 E GRAND AVE <br /> EVERETT, WA, 98201 EVERETT, WA, 98201 <br /> PHONE: 4255081148 PHONE: 4255081148 <br /> TAX PARCEL ID#: SITE ADDRESS: 2119 E GRAND AVE <br /> DESCRIPTION: REMOVE DIRT AND GRAVEL TO RESTORE BUFFER <br /> THIS PERMIT TO BE POSTED ON JOB SITE AT ALL TIMES <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 for Development'. <br /> 3. Call Location Underground Service 48 hours before you dig. The day you call does not count. TOLL FREE NUMBER 811. <br /> 4. Contact the City of Everett Public Works Inspector Randy Allen at 425-339-7403 prior to starting construction and with <br /> other inspection requests. See attached to request an inspection. �,n� ��;=5 <br /> ,__. ,__ � =� :,��,, <br /> 5. Install erosion control measures as determined by the Public Works inspector, such as silt:f,�nce,::��t��yy::,bales', swales, or <br /> �.. I :I�_' 't""'--1 ._. <br /> erosion blankets. =_:� �= �=`� <br /> ':l'l ._..i�"l'.�..� <br /> '_ _�n._�n--. i... <br /> _r:; ...__ <br /> 6. No dirt, mud, rocks, or debris to be tracked onto roadway. ': <br /> �.�.... �.�-,, - <br /> ,-�.... ���;`:-� <br /> �.�, � <br /> 7. Remove fill dirt and gravel within the 25 foot buffer area. Slope edge of remaining fill material back so as to minirrrr��; <br /> chances of erosion along bank. Hydroseed or replant entire area with vegetation as needed. `=: <br /> �,t ,:=.:; <br /> ��t�, - <br /> i�1 �-s; <br /> Pubiic Works Permit Fee Breakdown: �;=:� ;.�r:;�a ` <br /> f T,�'°'y �:��,_��_TI <br /> Misc. Minor Permits................................$25.00 <br /> �,f �--- <br /> �'� =='�=; i-...� <br /> ._.. ,-_, _ . <br /> __, _.. <br /> :�:� ,�.>> ,:->,::_: ,:.� o a <br /> PW Plan Review.......................................$20.00 �;�•;�=;.; <br /> PW Site Inspection..................................$20.00 �5 <br /> ,_..�,..�.� <br /> PLANNING DEPARTMEN ��/��'� <br /> City ofEverett O�cial Use Only ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save <br /> harmless the City of Everett from any and all claims for damages, costs, <br /> �•� �� � �� � expenses, or causes of action that may arise because of installation and <br /> �l maintenance of the improvement or other right-of-way use here to applied <br /> Appro d for Construction (Public Works) Date for and further agrees to remove same upon notice from the City and to <br /> replace public property damaged thereby. <br /> FINAL INSPECTION Date �"'�'���-� � � � � <br /> Approved as Constructed (PW Inspector) Sign ture of Applicant Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLETEION.THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90-DAY DURATION. <br />