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PUBLICO►ORKS PERMIT Date Applied: 12/7/2017 <br /> City of Everett Public Works Department Public Works Permit#: PW1712-018 <br /> �.a 3200 Cedar Street Parent Permit#: <br /> Everett,WA 98201 Planning Reference#: <br /> (425) 257-8810 Public Works Fee: $90.00 <br /> D7 DEC 2017 <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> DIVSAR AREF JOHNSON DWAYNE <br /> 4620 EVERGREEN WAY 2517 MUKILTEO SPEEDWAY <br /> EVERETT, WA, 98203-2840 MUKILTEO, WA, 98275 <br /> PHONE: PHONE: 4252462300 <br /> TAX PARCEL ID#: 00407801600500 SITE ADDRESS: 4620 EVERGREEN WAY <br /> DESCRIPTION: STOCK PILE SOIL ON SITE FOR FUTURE GRADING <br /> SOIL TO BE STOCKPILED FOR APPROXIMATELY 1 MONTH OR UNTIL CONSTRUCTION PERMITS ARE ISSUED. <br /> EROSION CONTROL MEASURES MUST BE IN PLACE AND MAINTAINED. <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 12/7/2017. <br /> Approved plans must remain on job-site at all times. -1:: -4 '=2 <br /> 5. Contact the City of Everett Public Works Inspector Randy Allen at 425-339-7403 prior to starting constructji*i fot,:a' <br /> consultation, to evaluate Erosion/Sedimentation control set-up, and with all other inspection rests:r2h <br /> 6. Install and maintain erosion control measures per City of Everett Standards and approved`S PPI' n. Remove upon <br /> completion of the project prior to final approval of the permit. c?.) -s=< �3 <br /> 7. Keep City streets clean at all times. No dirt, mud, rocks, or debris to be tracked onto roadway!- <br /> 8. Protect all existing underground utilities during construction. �' <br /> 9. All work constructed within the public right-of-way must be removed or relocated at the owner's expense if the Oityever <br /> requires use of the right-of-way for municipal purposes. <br /> • <br /> Public Works Permit Fee Breakdown: { <br /> • <br /> Grade/Fill/Excavate (Stockpile 200CY) $70.00 c° <br /> PW Site Inspection $20.00 <br /> -:3 <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 /> / <br /> (2, ? mai, expenses,or causes of action that may arise because of installation and <br /> 7 maintenance of them,,e'ovement or other right-of-way use here to applied <br /> pproved for Construction (Public Works) D to for and further . :f to remove same upon notice from the City and to <br /> replace pub %!arty damaged thereby. <br /> FINAL INSPECTION Date - f <br /> Approved as Constructed (PW Inspector) Signature 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 /> r1-�1� <br />