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PUBLIC�ORKS PERMIT • Date: 4/21/2015 <br /> Public Works Permit#: PWW1504-001 <br /> City of Everett Public Works Department <br /> �-�. � 3200 Cedar Street Building Permit#; BW1504-003 <br /> Everett, WA 98201 Planning Reference#: <br /> (425) 257-8810 <br /> Public Works Fee $: $ 85.00 <br /> Other $: <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> HAUGEN JAMES M HAUGEN JAMES M <br /> 3231 BROADWAY 3231 BROADWAY <br /> EVERETT Wq 98201 EVERETT WA 98201 <br /> PHONE: PHONE: 4252392823 <br /> TAX PARCEL ID# 00439076201000 SITE ADDRESS: 3231 BROADWAY AVE <br /> DESCRIPTION OF PROPOSED WORK: <br /> PAVING GRAVEL PARKING LOT <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. Civil construction work to be done per plan approved by Everett Public Works dated 7-20-15. (copy attached) ' <br /> w <br /> 5. Keep City streets and alley clean at all times. ' ' [--I <br /> _ M-� <br /> 6. Contact the City of Everett Public Works Inspector Randy Allen at 425-339-7403 prior to starting constructiori � <br /> and with other inspection requests. , � <br /> ;: � <br /> 7 Install erosion control measures as determined by the Public Works Inspector, such as silt fence, straw bales, , � <br /> swales, or erosion blankets. .`; Z <br /> i � <br /> ;,..��-..�::-�. <br /> Public Works Fee Breakdown: _=� '� ��;;_�;n�;? <br /> �„�; E"{ <br /> Plan Review$20.00 ;,,�;�-;;_ _ > � <br /> inspection $20.00 ' -;Q <br /> Asphalt Paving $45.00 � <br /> �� � � �� t f��� <br /> � ��y� k ����� ( <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and <br /> save harmless the City of Everett from any and all claims for <br /> damages, costs, expenses, or causes of action that may arise <br /> i because of installation and maintenance of the improvement <br /> � �2� �-- �7-y S' or other right-of-way use hereto applied for and further agrees <br /> to remove same upon notice from the City and to replace <br /> A proved for Construction Date public property damaged thereby. <br /> ^\ <br /> FINAL INSPECTION Date � (1���r C-i�-�-' • 1 ( �� <br /> Approved as Constructed r <br /> Signature of Applicant 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 />