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PUBLIC WORKS P�RMIT Date: 1/15/2013' ' <br /> Public Works Permit#: PW1301-007 <br /> City of Everett Public Works Department <br /> 3200 Cedar Street Building Permit#; C1209-004 <br /> �� Everett, WA 98201 <br /> (425) 257-8810 Planning Reference#: <br /> Public Works Fee $: $ 25.00 <br /> Other $: <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> COLYN DENNIS COLYN DENNIS <br /> 4601 21 ST DR W 4601 21 ST DR W <br /> EVERETT Wq 98203 EVERETT Wq 98203 <br /> PHONE: 4253598570 PHONE: 4253598570 <br /> TAX PARCEL ID# 00393500001806 SITE ADDRESS: 307 80TH PL SW <br /> DESCRIPTION OF PROPOSED WORK: <br /> FILL LOW AREA <br /> FILL IN LOW SPOT BTWN PROPERTIES TO BE LEVEL WITH EXISTING GRADE ON BOTH SIDES OF PROPERTY <br /> LIN E <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. Fill must be placed as shown on the site plan and critical area fence and critical area left undisturbed. <br /> 5. Raise catch basin rim and lid to grade per city standard#402. w <br /> Your Public Works Inspector is Randy Allen. Call him at 425-339-7403 for questions and inspections _� �"� <br /> �_ h� <br /> �:� � <br /> . � <br /> � <br /> � <br /> F+ <br /> � <br /> 4�::,i <br /> TT��� " T�/� <br /> =�a�,�ti' �'i�i� . . Vl <br /> _, �. O <br /> � <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 /> _ because of installation and maintenance of the improvement <br /> �� -- ;- y.,� �` .� or other right-of-way use hereto applied for and further agrees <br /> A r ed or Constr % ate to remove same upon notice from the City and to replace <br /> pp ��� ���s"'— ' li property damaged thereby. <br /> G �- z� -�j r � �- -� _ � <br /> FINAL INSPE ON Date �— � <br /> Approved as Constructed Signature of Applicant Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFT�ER 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 />