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PUBLIC WORKS PERMIT Date: 3/31/2017 <br /> City of Everett Public Works Department Public Works Permit#: PW1703-076 <br /> 3200 Cedar Street Parent Permit#: <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 /> CASINO-WESTMONT AFFORDABLE HOUSING BASIS ARCH <br /> 2223 112TH AVE NE STE 102 <br /> BELLEVUE WA 98004 <br /> PHONE: PHONE: <br /> TAX PARCEL ID# 00392100000700 SITE ADDRESS: 824 W CASINO RD <br /> SITE WORK FOR CLUB HOUSE AND APARTMENTS <br /> 930 SF PAVING <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 3/31/2017. <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 I� <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. <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 <br /> neighboring properties, including the City's right-of-way and/or easements and the <br /> improvements located therein. <br /> 10. Proposed paving totals 930sf. Drainage mitigation will be triggered if paving/hard E..l <br /> surfaces exceeds 2000sf, at which time a separtate permit will be needed. <br /> Public Works Permit Fee Breakdown: <br /> Paving (930SF) $45.00 Pi <br /> PW Plan Review $20.00 <br /> PW Site Inspection $20.00 <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harmless the <br /> )Ji-i1h <br /> 41 `y7 ����`^^'l 373/70V <br /> /2` 0V City of Everett from any and all claims for damages,costs,expenses,or <br /> t J/ GU causes of action that may arise because of installation and maintenance of the <br /> improvement or other ri• t-of-way use hereto applied for and further agrees to <br /> Approved for Construction Date <br /> remove same upon f• the City and to replace public property <br /> dam. -d ereby. <br /> FINAL INSPECTION Date <br /> Approved as Constructed <br /> /IMO, lb l Xi <br /> pp Sign it f Applic:nt Da e <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATEATPERMIT 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 />