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� � 1z�� ic� <br /> PUBLIC WORKS PERMIT Date: 1�1 <br /> Public Works Permit#: PW1611-012 <br /> City of Everett Public Works Department <br /> 3200 Cedar Street Parent Permit#: B1610-045 <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 /> KEPFORD PAMELA J <br /> 5129 EVERGREEN WAY PMB 4D-153 <br /> EVERETT WA 98203 <br /> PHONE: PHONE: <br /> TAX PARCEL ID# 00495800800800 SITE ADDRESS: 5621 ROCKEFELLER AVE � <br /> DRAINAGE AND EROSION CONTROL FOR NEW GARAGE <br /> Remove and replace existing carport with new garage. <br /> _AUREL HEIGHTS BLK 008 D-00 - LOT <br /> 8 <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 /> -, . <br /> 4. Contact the City of Everett Public Works Inspector Randy Allen at 425-339-7403 prior- -- - � <br /> to starting construction and with other inspection requests. -- ,_;._,�,_ -,:, ;.;, � <br /> 6. Install erosion control measures per City of Everett Standards for small parcels:and =-��;,; ,` <<;f i ' ' w <br /> remove upon completion of the project prior to final approval of the permit. " ���'`:' ' ' ' [�I <br /> ,..: <br /> 7. Keep City streets clean at all times. No dirt, mud, rocks, or debris to be tracked onto , I-, � <br /> roadway. �-� <br /> 8. Protect all existing underground utilities during construction. - !. � <br /> 9. Downspouts for new garage shall discharge to splash blocks. O <br /> Public Works Permit Fee Breakdown: � <br /> Misc. Minor Permits (Drainage &TESC).........$25.00 � • ; ' , , '; ; '� <br /> i r� <br /> PW Plan Review.............................................$20.00 _, �,,�... o�.�, �;_., -- <br /> ..... �- <br /> �_, c�'i r__'i r�;�r.>>-ti::.,�_,'_. <br /> PW Site Inspection..........................................$20.00 � ,i��,:-�,__.,��._,,_-,�r,.��><_.� . ,'Q <br /> � <br /> � <br /> � <br /> � <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 /> improvement or other right-of-way use hereto applied for and further agrees to <br /> Approved for Construction Date remove same upon notice from the City and to replace public property <br /> damaged thereby. <br /> FINAL INSPECTION Date �i �; _ ` � <br /> Approved as Constructed Signature of Applic t 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 /> �� <br />