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PUBLIC -CORKS PERMIT —ate Applied: 7/11/2018 <br /> City of Everett Permit Services Public Works Permit#: PW1807-012 <br /> 3200 Cedar Street, 2nd Floor Associated Bldg Permit#: <br /> Everett,WA 98201 Planning Reference#: <br /> (425) 257-8810 Public Works Fee: $65 <br /> 12 J U L 2018 <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> JOYCE SCOTT Owner <br /> 1321 KOSSUTH AVE [AppAdd] <br /> EVERETT, WA, 98203 [AppCi], [AppSt], [AppZip] <br /> PHONE: 2693620653 PHONE: [AppPhone] <br /> TAX PARCEL ID#: 00394100100800 SITE ADDRESS: 1321 KOSSUTH AVE <br /> DESCRIPTION: INSTALL CULVERT IN DITCH AND FILL WITH GRAVEL <br /> (7/11/2018 12:59 PM PTM) <br /> 8-inch ADS pipe on a gravel bed in existing drainage ditch to be connected with fernco fittings to existing pipes, then filling <br /> with gravel-area to be used as street-side parking <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. No dirt, mud, rocks, or debris to be tracked onto roadway. <br /> m "-i ni <br /> 5. Contact the City of Everett Public Works Inspector Jim Knappert at 425-339-7404 prior to...st,arting ormst6gdiion <br /> and with otherinspection requests. -1 <br /> --I-t - <br /> ca <br /> 6.All work shall be performed in accordance with the City of Everett's current Design and Cortistruictatiandkds and <br /> Specifications for Development and the attached schematic plan. -; <br /> 7. Maintenance responsibility for the new gravel surface shall rest with the abutting property owner. 3 <br /> 8. Protect all existing underground utilities during construction. Adjust existing water meter box to new grade. �J-, <br /> 1,3 <br /> CD <br /> Public Works Permit Fee Breakdown: <br /> Misc. Minor Permits (Drainage Work) $25.00 1 nom* <br /> PW Plan Review $20.00 col0 F.,"c..)(.31ez, <br /> PW Site Inspection $20.00 ' _° c-,�' <br /> --a...in. <br /> N., <br /> 0 <br /> City of Everett Official Use Only ACKNOWLEDGEMENT OF CONDITIONS <br /> ri 11 laii <br /> COIL <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 /> 07/11/18 expenses,or causes of action that may arise because of installation and <br /> maintenance of the improvement or other right-of-way use here to applied <br /> Ap roved for Const ction (Public Works) Date for and further agrees to remove same upon notice from the City and to <br /> replace public property damaged thereby. <br /> FINAL INSPECTION Date 4 e —7—12---1 <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 />