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to I <br /> Date: 8/ 1? <br /> PUBLIC WORKS PERMIT Public Works Permit#: PW1608-044 <br /> City of Everett Public Works Department <br /> 3200 Cedar Street Parent Permit#: C1608-018 <br /> Tr Everett, WA 98201 Planning Reference#: <br /> (425)257-8810 <br /> Public Works Fee$: $ 140.00 <br /> Other$: <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> TSYMBALYUK VOLODYMYR/LINA TSYMBALYUK VOLODYMYR/LINA <br /> 505 103RD PL SE 505 103RD PL SE <br /> EVERETT WA 98208 EVERETT WA 98208 <br /> PHONE: 4252931892 PHONE: 4252931892 <br /> TAX PARCEL ID# 00531700500400 SITE ADDRESS: 6406 HIGHLAND DR <br /> SITE DEVELOPMENT FOR NEW SFR DETACHED <br /> NORTH BEVERLY PARK DIV 2 BLK <br /> 005 D-00 -LOT 4 <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 by the City of Everett Public Works <br /> Department dated 9/22/2016. <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. [tel <br /> 6. Install erosion control measures per City of Everett Standards and remove upon Mei <br /> completion of the project prior to final approval of the permit. <br /> 7. Keep City streets clean at all times. No dirt/mud/rocks/debris to be tracked onto <br /> roadway. <br /> 8. Protect all existing underground utilities during construction. <br /> 9. It is the applicant/owner's responsibility to ensure that stormwater runoff from new <br /> impervious surfaces will be managed on-site in a manner that does not adversely affect e ! <br /> ri <br /> neighboring properties, including the City's right-of-way and/or easements and the <br /> improvements located therein. <br /> 10. As-builts of storm sewer, sanitary sewer, and water systems are required to be OCT 0 7 2016 /r••� <br /> submitted prior to final approval. Car <br /> Public Works Permit Fee Breakdown: CITY OF EVERETT C <br /> Driveway $25.00 Permit Services <br /> Misc. (Drainage Work) $25.00 !u�� <br /> Grading/Fill/Excavate $50.00 POSTING <br /> PW Plan Review $20.00 <br /> PW Site Inspection $20.00 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 /> 1._Zz 246b causes of action that may arise because of installation and maintenance of the <br /> Approved for Construction Date improvement or other right-of-way use hereto applied for and further agrees to <br /> remove same upon notice from the City and to replace public property <br /> damaged thereby. <br /> FINAL INSPECTION Date 1,0(0-, 1110 <br /> Approved as Constructed Signatur 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 />