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PUBLIC RKS PERMIT Date: 6/4/2014 <br /> City of Everett Public Works Department Public Works Permit#: PW1406-004 <br /> • 3200 Cedar Street Building Permit#; <br /> Everett, WA 98201 Planning Reference#: <br /> (425)257-8810 <br /> Public Works Fee$: $ 320.00 <br /> Other$: <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> Everett Clinic-Scott Lawson AMEC Environment-Meg Strong <br /> 3901 Hoyt Ave 11810 N Creek Parkway N <br /> EVERETT WA 98201 BOTHELL WA 98011 <br /> PHONE: 4252590966 PHONE: 4253681000 <br /> TAX PARCEL ID# SITE ADDRESS: 3827 Rucker Ave <br /> DESCRIPTION OF PROPOSED WORK: <br /> Excavation and removal of soil <br /> (6/4/2014 9:20 AM BES) <br /> Excavation and removal of contaminated soil and regular soil. <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. Traffic control shall be per approved plan 5/1/2014. <br /> 5. Install erosion control measures per Ciyt of Everett Standards for small parcels. .;; <br /> 6. Remove erosion control measures upon completion of the project prior to final approval of the permit,— '' p°;c <br /> 7. No dirt, mud, rocks or debris to be tracked onto roadway. <br /> 8. Contractor must contact the City of Everett Inspector Randy Allen 425-339-7403 prior to startinc5n •ion c) <br /> s <br /> ' I—II <br /> r� c rt 1 <br /> C44, <br /> om'_"} TI r-- <br /> -F ru <br /> �C` <br /> { •Fi <br /> r•� v r•� <br /> {�} P } <br /> Cx O : <br /> C:x Y Cx <br /> Cx c,Yx -1 <br /> C.-7J_ir L.. <br /> FSM <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and <br /> save harmless the City of Everett from any and all claims for <br /> damages,costs,expenses, or causes of action that may arise <br /> because of installation and maintenance of the improvement <br /> 4141 <br /> i6 <br /> or other right-of-way use hereto applied for and further agrees <br /> pp�•vedto remove same upon notice from the City and to replace <br /> for Constr •n Date public property damaged thereby. <br /> FINAL INSPECTION Date `ck (-0- 4-0( <br /> Approved as Constructed 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 <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 />