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PUBLIC �ORKS PERMIT � Date: 12/28/2015 <br /> Public Works Permit#: PW1512-027 <br /> City of Everett Public Works Department <br /> �;• '�' <br /> 3200 Cedar Street Building Permit#; B1512-005 <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 /> CREAMER ROBERT J <br /> 2616 BAKER AVE <br /> EVERETT Wq 98201-3136 <br /> PHONE: PHONE: <br /> TAX PARCEL ID# 00437860402100 SITE ADDRESS: 2616 BAKER AVE <br /> FOUNDATION ONLY W/ INFILTRATION TRENCH <br /> =VERETT DIV I PLAT OF BLK 604 D-00 <br /> - LOTS 21 &22 <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 (as modified) by the City of Everett <br /> Public Works Department dated 12/28/2015. 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. See attached to request an E--I <br /> inspection. � <br /> 6. No dirt, mud, rocks, or debris to be tracked onto roadway. Keep City streets clean at <br /> all times. � <br /> 7. Infiltration trenches shall be constructed in accordance with Figure 3.1.2 in Volume III O <br /> of the Stormwater Management Manual for Western Washington (SWMMWW) and as � <br /> noted on the plans. Two parallel trenches shall be constructed at 15' long by 5' wide by �� � � <br /> 2' deep, each, in order to provide adequate bottom area for the contributing area and � 'Z <br /> reduce flooding/settlement hazards. �AN � 3 Z��6 � O <br /> Public Works Permit Fee Breakdown: � � <br /> Misc. Minor Permit(Tightlines, Infiltration Trench, Steps) $25.00 CITY OF EVERETT � <br /> PW Plan Review$20.00 Permit Services O <br /> PW Site Inspection $20.00 �,.�, ��1,� (����}- <br /> -�� _. a <br /> ���� � �g r� � <br /> . °.r �'_ <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harmless the <br /> /-7 City of Eve tt from any and all claims for damages, costs,expenses,or <br /> r 12/? ��, c� �_ (Ol-�.�`" ���5 ca of tion that may arise because of installation and maintenance of the <br /> i r e�n nt or other right-of-way use hereto applied for and further agrees to <br /> Approved for Construction Date rs �s a--aafice f_rom the City and to replace public property <br /> g thereby. � � <br /> FINAL INSPECTION Date � � ��, / / � �� <br /> Approved as Constructed ign ture of nt Dat <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF ATE E MIT I ISSUED AND THEREAFTER IS TO BE DILIGENTLY <br /> PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UP N Y STO AGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br /> �v�£ <br />