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PUBLIC WORKS PERMIT Date: 11/3/2016 <br /> Public Works Permit#: PW1611-010 <br /> City of Everett Public Works Department <br /> 3200 Cedar Street Parent Permit#: BW1605-003 <br /> Everett, WA 98201 Planning Reference#: <br /> (425) 257-8810 <br /> Public Works Fee $: $ 45.00 <br /> Other $: <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> ERGLER CHALENE P WISELY JAMES <br /> 5107 DELAWARE AVE <br /> EVERETT �/�/q 98203 <br /> PHONE: PHONE: 4255821295 <br /> TAX PARCEL ID# 00480200100500 SITE ADDRESS: 9224 HOLLY DR <br /> REMOVE ASPHALT AND REPLACE WITH LANDSCAPING <br /> Driveway to be restored to 12'width with landscaping on either side. <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 11/3/2016. <br /> 5. Contact the City of Everett Public Works Inspector Jim Knappert at 425-339-7404 w <br /> prior to starting construction and with other inspection requests. [� <br /> 6. Install erosion control measures per City of Everett Standards for small parcels and � <br /> remove upon completion of the project prior to final approval of the permit. <br /> 7. Keep City streets clean at all times. No dirt, mud, rocks, or debris to be tracked onto � <br /> roadway. O <br /> 8. Protect all existing underground utilities during construction. � <br /> 9. Area where asphalt is removed must be landscaped. No bare or uncovered soils <br /> allowed for more than 2 days from Oct. 1-April 30th or 7 days from May 1-Sept. 30th. `� <br /> Public Works Permit Fee Breakdown: �' ��.��,, O <br /> Misc. Minor Permits (Restoration/Landscaping).......$25.00 ��� 44� �� �� �..� <br /> PW Site Inspection...................................................$20.00 ' j � <br /> ��� ��� - 5 ?Q�S I .+ O <br /> �. � � <br /> �'ITY �AF��E �, <br /> ��'r+)irt CJ`, ��.�� <br /> ' �"1Cr=; <br /> 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 /> � /(�3._..�� causes of action that may arise because of installation and maintenance ofthe <br /> improvement or other right-of-way use hereto applied for and further agrees to <br /> pproved for Construction Date remove same upon notice from the City and to replace public property <br /> damaged thereby. <br /> FINAL INSPECTION Date , � � Z—!�=� (; <br /> Approved as Constructed ature 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 /> �.{�t�G.� <br />