902 N BROADWAY IN N OUT MINI MARKET 2019-05-31

PUBLIC WORKS PERMIT Date Applied: 11/27/2017 elp. City of Everett Permit Services Public Works Permit#: PW1711-030 3200 Cedar Street, 2nd Floor Associated Bldg Permit#: 1011111111,--A Everett,WA 98201 * tanning Reference#: v//// _ - - (425)25T-88 o Public Works Fee: $460 a. OWNER NAME AND ADDRESS: APPLICANT NAME AND ADDRESS: NAP MANAGEMENT, Inc.- DAVE HUNTER KANE ENVIRONMENTAL- ERIC NASSAU 7525 SE 24TH ST P.O.BOX 31936 MERCER ISLAND, WA, 98040 SEATTLE, WA, 98103 PHONE: PHONE: 2066910476 TAX PARCEL ID#: 29051700201100 SITE ADDRESS: 902 N BROADWAY DESCRIPTION: DECOMMISSIONING AND REMOVAL OF THREE GAS STATION USTs (10/24/2017 2:56 PM BES) (10/24/2017 2:52 PM BES) DECOMMISSIONING AND REMOVAL OF THREE GAS STATION USTs, AND ASSOCIATEDPIPING, DISPENSERS AND DISPENSER CANOPY. THE PARKING LOT WILL REPAVED. A SOIL VAPOR EXTRACTION SYSTEM WILL BE INSTALLED TO REMIDIATE ON-SITE PETROLEUM CONTAMINATED SOIL AND GROUNDWATER. NO WORK IN THE RIGHT-OF-WAY. THIS PERMIT TO BE POSTED ON JOB SITE AT ALL TIMES PERMIT CONDITIONS: 1. All calls for inspection shall be made 24 hours in advance. 2. All work shall be performed in accordance with the permit and current City of Everett`Design and Construction Standards and Specifications for Development'. 3. Call Location Underground Service 48 hours before you dig. The day you call does not count. TOLL FREE NUMBER 811. 4. Site Civil Work to be done per plans approved by the City of Everett Public Works Department dated 11/02/2017. Approved plans must remain on job-site at all times. 5. Contact the City of Everett Public Works Inspector Randy Allen at 425-339-7403 prior to starting construction for a consultation, to evaluate Erosion/Sedimentation control set-up, and with all other inspection requests. 6. Install temporary constuction entrance per City standards. 6. Install and maintain erosion control measures per City of Everett Standards. Remove upon completion of the project prior to final approval of the permit. 7. Keep City streets clean at all times. No dirt, mud, rocks, or debris to be tracked onto roadway. 8. Protect all existing underground utilities during construction. 9. If the prposed fill is intended to support structures in later date, the fill shall be placed in accordance with Appendix J of the international Building code. If the applicant does not intend to do that the applicant is required to submit a letter to the City stating so. The letter will be recorded against the property. 10. If discharge is necessary fill"Industrial Discharge Approval Request Form" prior to discharging. 11. All contaminated soil and excavated materials from the removal of the ground shall be hauled and deposited to an approved, permited site. 12. Obtain permit from fire department for tank removal. Public Works Permit Fee Breakdown: Erosion Control Pla ¢j ,(iJ /y...$200.00 ACKNOWLEDGEMENT OF CONDITIONS Grade/t-ili/txcavate (5UU (;Y) $15U.UU The undersigned owner/applicant hereby agrees to hold and save Parking Lot Paving(14,000 SQFT) $70.00 harmless the City of Everett from any and all claims for damages,costs, PW Plan Review $20.00 expenses,or causes of action that may arise because of installation and maintenance of the improvement or other right-of-way use here to applied IOWA'IBP6Rikructiorr.(Public Works)$20.00 Date for and further agrees to remove same upon notice from the City and to replace public property damaged thereby. FINAL INSPECTION Date Approved as Constructed (PW Inspector) Signature of Applicant Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETEION.THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90-DAY DURATION.