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26 SEP 2017 <br /> PUBLIC WORKS PERMIT Date Applied: 9/26/2017 <br /> City of Everett Public Works Department Public Works Permit g: PW1709-046 <br /> • � 3200 Cedar Street <br /> Parent Permit#: <br /> Everett, WA 98201 Planning Reference#: <br /> (425) 257-8810 Public Works Fee: $25 <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> DE CRUZ PAULA D HENRIQUEZ DE CRUZ PAULA D HENRIQUEZ <br /> 11021 1ST AVE SE 11021 1ST AVE SE <br /> EVERETT, WA, 98208 EVERETT, WA, 98208 <br /> PHONE: 4257375900 PHONE: 4257975900 <br /> TAX PARCEL ID #: 00391500001600 SITE ADDRESS: 11021 1ST AVE SE <br /> DESCRIPTION: INSTALL CULVERT IN EXISTING DITCH ALONG PROPERTY FRONTAGE <br /> APPROXIMATELY 50 FT <br /> THIS PERMIT TO BE POSTED ON JOB SITE AT ALL TIMES <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 for Development'. <br /> 3. Call Location Underground Service 48 hours before you dig. The day you call does not count. TOLL FREE NUMBER 811. <br /> 4. Site Civil Work to be done per plans approved by the City of Everett Public Works Department dated 09/26/2017. , .... <br /> Approved plans must remain on job-site at all times. `,. <br /> 5. Contact the City of Everett Public Works Inspector Jim Knappert at 425-339-7404 prior to stat h cot #ructuon for a <br /> consultation, to evaluate Erosion/Sedimentation control set-up, and with all other inspection reque ; <br /> 6. Keep City streets clean at all times. No dirt, mud, rocks, or debris to be tracked onto roadway. .a rte, <br /> r.D <br /> 7. Use same pipe material as existing. Review inlet protection with inspector. i---•' <br /> ND <br /> wo <br /> 60 <br /> 1 <br /> Public Works Permit Fee Breakdown: P.J ,. <br /> Misc. Minor Permits (Drainage Work) $25.00ni <br /> £F.F Hi•! -r.61- <br /> -1.. .,F-- <br /> G-.. <br /> City of Everett Official Use Only ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save <br /> harmless the City of Everett from any and all claims for damages, costs, <br /> �' j it _ 9-26 -17' expenses,or causes of action that may arise because of installation and <br /> j �' — maintenance of the improvement or other right-of-way use here to applied <br /> Ai): •ved for Cg struction (Public Works) Date for and further agrees to remove same upon notice from the City and to <br /> replace public pr. damaged thereby. <br /> ...____. \* --\-(:::-- -- / -o23-/F <br /> FINAL INSPECTIO Date V� oy/2 / ` <br /> Approved as Constructed (PW Inspector) • . e 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 PURSUED TO <br /> COMPLETEION.THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90-DAY DURATION. <br />