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JUL LU 1I <br /> 1pfr PUBLItOIORKS PERMITIII Date Applied: 7/28/2017 <br /> °` "' City of Everett Public Works Department <br /> PublicWorks Permit#: PW1707-053 <br /> 3200 Cedar Street Parent Permit#: <br /> Everett,WA 98201 Planning Reference#: <br /> (425) 257-8810 Public Works Fee: $65 <br /> OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: <br /> CITY OF EVERETT APPLIED PROFESSIONAL SERVICES <br /> 3200 CEDAR ST 43530 SE NORTH BEND WAY <br /> EVERETT, WA, 98201 NORTH BEND, WA, 98045 <br /> PHONE: 4252578810 PHONE: 4258882554 <br /> TAX PARCEL ID#: SITE ADDRESS: 905 WETMORE AVE <br /> DESCRIPTION: POTHOLE EXISTING UTILITIES FOR CITY PROJECT DESIGN <br /> THIS WORK WILL DETIRMINE THE DEPTH AND LOCATION OF UNDERGROUND UTILITIES FOR PROJECT DESIGN <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. Traffic Control must be done in accordance with MUTCD Standards and the Traffic Control Plan approvedr Cityi <br /> Everett dated 07/28/12017. <br /> C <br /> .....4 <br /> 5. Contact the City of Everett Public Works Inspector Randy Allen at 425-339-7403 prior to s IriAA4uctiai, to <br /> evaluate traffic control set-up, with other inspection requests, and to final the permit. j.12 , IF, <br /> 6. Provide an adequate temporary patch as directed by the Public Works Inspector. :; ; ; <br /> Ial I <br /> .;�' <br /> 7. Contact Everett Transit(Skip Algard 425-257-7765) three days prior to starting work. salgard@everettwa.gov ; <br /> Lri <br /> ,. .9 . ,. .jr ...• <br /> Public Works Permit Fee Breakdown: Uri 0 <br /> Misc. Minor Permits (Drainage Work) $25.00 —4` ;r- � <br /> PW Plan Review $20.00 '' <br /> PW Site Inspection $20.00 <br /> City of EverettOfcial 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 /> tii/V81,01342— <br /> 7 -Za ".f 7 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 /> Approv for Construction (Public Works) Date for and further agrees to remove same upon notice from the City and to <br /> replace ...li .roperty damage ereby. <br /> FIN �— 3 <br /> AL INSPECTION Date <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 />