10032 19TH PL W 2026-04-13 - Laserfiche WebLink

PUBLIC WORKS PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETTSUBMRl INSTRUCTION : Email xppll[eIM S women daumenbW FwmM1Bervlw¢($ee'renlMa.go, or ErtP of at 320) Order Sri and Fear Drop WASHPINGTON CONTACT INFON nON. E) 425 25T 88101(E) Permu ervlces@overa aki l BY)evmetlxa.pw/Pormils P CT SITE INFORMATION PROJECT ADDRESS: 1003219Ih Place W SITE WORK FOR PROJECT TYPE: 135FR-DETACHED [TOWNHOUSE OOUPLEA OADU OMUITFAMILY [COMMERCIAL [INDUSTRIAL IF APPLICABLE: 0 )AND USE PROJECT k (SERA, PRE ARE, SS. ETC.) CE24-0407 IF APPLICABLE: I]FRANCHISENTILITY COMPANY, ANNUAL BLANKET PERMIT A UTILITY COMPANY'S NAME a JOB k: JOB k: DESCRIPTION OF SI FILL IN ALL QUANTITIES OF WORK BELOW AS APPLICABLE: ❑ FENCE IN ROW FT IN HEIGHT ❑ DRIVEWAY APRON I CURB CUT FTWIDE O ASPHALT I CONCRETE PAVING SF ❑ RETAINING WALL I ROCKERY IN RIGHT-OF-WAY LF ❑ RETAINING WALL I ROCKERY OVER JET IN HEIGHT FT TOTAL HEIGHT ■ CLEARING) GRADING) FILLI EXCAVATE 1,936SF 10GY ❑ CUTWRE IN PAVEMENT( PARALLEL) LF O CUTWRE IN PAVEMENT( NON -PARALLEL) LF ❑ POLE WORK I AERIAL I OVERLASH LF ADDITIONAL DESCRIPTION AS NEEDED): F-WAY WORK DRAINAGE MITIGATION QUESTIONS: STORMWATER DISCHARGES TO: Dcombined samer O separrad Storm Sever ■ Direct Diamparge to Surinmisb River or Puget Sound TRIGGERED REQUIREMENTS: 13MR20nly EIMRU5 DUBUC QUANTITY OF PROPOSED HARD SURFACES: Proposed RMAAMM O SF Proposed Handsome: 0 BE Tonl New a Replaced 0 BE 1 936 s uare feet Of trees were removed from Wetland A and will be replaced b instalen native trees. A soil berm is proposed to be installed parallel with Swamp Creek in the lawn area to provide minor flood pro ec Ion CONTACT I N FO RMATI ON OWNER I APPLICANT NAME: Jettle A. Weeden-IShman OWNER I APP. MAILING ADDRESS mREET1003219th Place Ty Everett ATC WA ZIP 98204 OWNER IMP. PHONE:(206) 650-7150 OWNER I APP. EMAIL:)aweedenlshman@frontlePGOm 'Requtred for Work In Public Rig hto! Way CONTRACTOR NAME: N/A, NO Work proposed In ROW CONTRACTOR ADDRESS: CONTRACTOR PHONE:- CONTRACTOREMAIL:- CONTRACTOR LICENSE NIREDUIRED): - EVERETT BUSINESS LICENSE #(REQUIRED): - PRIMARYCONTACT: ❑ OWNER I APPLICANT ❑CONTRACTOR 0OTHER (Arehitect, Engineer, Etc.) Ecologist CONTACT NAME: Alex WaCMer. Wellantl Resources, Inc. CONTACT PHONE 1425)337-3174 CONTACT EMNL:alex@wegantlresoumes.com ACKNOWLEDGEMENT I have reWmwtl this appabiaken amid wn(mn Me ier nextiom mmhimd hei isTom And wmli. Work Mrwp rketplro Mk par at meet eomply with m encere Amoco, water and ucal lawme grenrng wa parand any members appmred vo kaw Me dawarwrs theresum. Generators met nrn ee eNlMmd M mi14g ham Me Bulldmg OMcb/ behre being eNlMmtl underany cirerrodg ene. I am Me owner, a l not arranged by Me owner dthis repeatedly to perbmr acre work for Much eppVaefirn is made, and I comply near the State Conheaom' Law 1827 RCW mar 296.2004 MAC. Cary ofE"i OMnel Use Gary FEKMI PW OwneMAuthorizad Agent Signature pate (ReWe14212022)