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y'�� <br /> � Date: 11/3/2016 <br /> PUBLIC��ORKS PERMIT _ <br /> Public Works Permit#: PW1611 005 <br /> City of Everett Public Works Department <br /> ���� 3200 Cedar Street Parent Permit#: <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 /> DAGMARS MARINA LLC VINCULUMS SERVICES FOR VERIZON WIRELESS <br /> 1200 112TH AVE NE#C-185 3301 BURKE AVE N STE 100 <br /> BELLEVUE �/�/q 98004 SEATTLE Wq 98103 <br /> PHONE: PHONE: 2066618998 <br /> TAX PARCEL ID# 29050900200900 SITE ADDRESS: 1871 ROSS AVE <br /> TRENCH AND BORE FOR VERIZON WIRELESS <br /> New 17"x30"x36" deep hand hole to be placed at the private property line near the public right-of-way(Smith Island Rd.). <br /> New 4" conduit to be bored 36" deep from new hand hole to the Verizon cell site, approximately 190'. All other work will <br /> take place within the Verizon cell site compound. <br /> SCC NO 76400 SLY OF JOHNSON <br /> SLOUGH & ELY OF E BK UNION <br /> CUT-OFF SLOUGH (AKA SMITH <br /> PERMIT CONDITIONS ON SURV REC IN VOL 8 PG 146 UND <br /> 1. All calls for inspection shall be made 24 hours in advance. AFN 7810230267 TGW E BK UNION <br /> 2. All work shall be performed in accordance with the permit and current City of Everet�����r�l �p��u��§t��i�rj� <br /> and Specifications. <br /> 3. Call Location Underground Service 48 hrs before you dig. TOLL FREE NUMBER 811 - ; :;:; <br /> 4. No conern for Traffic Control :, <br /> , <br /> 5. Any damage to City improvements (sidewalk, curb, roadway, etc.)shall be replaced �' <br /> r��� <br /> per City Standards and/or as directed by the City PW Inspector. � T; ' ' w <br /> 6. A minimum of 5ft separation between City of Everett utilities and directional � � _ [�I <br /> boring/pavement cuts shall be maintained. � <br /> 9. Contact the City of Everett Public Works Inspector Randy Allen at 425-339-7403 prior �-�' <br /> to starting construction, to evaluate traffic control set-up, and with other inspection - ' � <br /> requests. `__� O <br /> 10. Coordinate with adjoining businesses/homeowners to minimize obstruction of 'r�?;a <br /> commerce/access. ;;±;; _�;' � <br /> _-:.a ;�-�.�.�..�rt �. : � <br /> -.,. <br /> :. <br /> ,.,.... r�._�r•._�r�..a <br /> Public Works Permit Fee Breakdown: `:f'��:^-�,�'}`"�, <br /> r <br /> ��_ „ ,� , . <br /> �_:.=r.w� ="'.;;-_.':;;`='; ,::��r,' <br /> Misc Minor Permit And?Or Plan Reviews......$25.00 `�' � <br /> ,.... <br /> ; ..........:.:, <br /> PW Plan Review........................................................$20.00 ;... . E..� <br /> _: ,::�;; <br /> PW Site Inspection....................................................$20.00 � <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 /> �� �� � �f,� causes of action that may arise because of installation and maintenance of the <br /> pproved for Construc , Date improvement or other righ-of-way use hereto applied for and further agrees to <br /> remove same upon no rom the City and to replace public property <br /> damaged�reby. I <br /> ,'% <br /> FINAL INSPECTION Date `�;% �� - � •-y- <br /> Approved as Constructed i a ur o Appiican� Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DA�OF DATE PERMI3=I�I�SUED 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 />