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AOPlicetion For D `-� � � � <br /> � PUBLIC WORKS PERMIT �e=e 2/20/96 _ <br /> ��,�„ � <br /> PUBLIC WORKS DEPARTMENT Pubiic Works Permit N <br /> 3200 Ceda�Street . — -- <br /> Everett,WA9820? 259-88�0 <br /> Building PermN k_�r��08 <br /> TVPEORPRINTONLY TO POSTING "� publicWorksFae$ � <br /> A1 Jubie I821 19th Dr Mukilteo 98275 290-1A56 <br /> �^� Aia�lir.g Address City Zi�p Phone <br /> Applicant Mailing Address City Zip Phone <br /> DBscribeProposedWork New house - Basic i115 � <br /> � . <br /> PROJECT ADDRESS(if known) Z2� /�dam� qve. �� ` _�'`'G�5`' �� <br /> Attach four(4)copies of plans tor proposed work-Draw to scale and note the following if applicable: � <br /> f.:. �'JJ�J�ua O <br /> 'Aoperty Lines �Outline and dimensions of all existing antl.�roposed structures on the lot •Existing and pr�pa@d�{tjli(i�s <br /> `Centerline of street •Intlicate North �Show any proposed grading chpnges �Show measurements $�• �� ��� � <br /> 1.r�u\J SY��I4 <br /> O NOT WRITE BELOW THIS LINE --"'- <br /> PERMITCONDITIONS: - - -;•�+�+ � <br /> 1.All calis for inspection sh�ll be made 24 hours in advance-phone 259-8810. <br /> 2.All work shall be pertovmed in accordance with this permit and curreot City of Ev€rett[)esigr�arid O <br /> Construction£tandards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 9-800-424-5555, � <br /> 4. Rooitop drainage shall be discharged: �// <br /> a) I'o the site's storm drain aystem(private or public) � <br /> b) Tu a resideutial roof docvy�spout ays�em desi,qned pr,aectiot�4-9:i uf U�e � <br /> city standards <br /> c) C�nto splash blocks <br /> 1fie method salected will be subsec�to Public Work� lleqartemea�t appi•o��al. <br /> i. Driveway must be paved from pra�perly lme to edge of etreet pavernemt. <br /> 6. Replace sidzsewer to properh Iine and instali ��ew as per standard plen#b01. <br /> � d <br /> ACKNOWLEDGEMFNT OF CONDIT!ONS <br /> —� The undersigned ovanedapplicam hereby agrees to h�W and save harmless <br /> � the City of Eve�ett from any and all claims for damages,costs,expenses,oi <br /> etl for tru on pgqe causes of action that may arise becaose of installtY.ion and maintenance of <br /> . '/ theimprovementorothernght-ot-wayuseheretoappliedforandfurtheragrees <br /> !/ to remove same upon notice from the City and to replace public prope�ty <br /> - �,y�- � damageri theraby. <br /> � L INSPECTION � Date <br /> Approved as Corsstructed _� `�� <br /> Signature o licant Cate <br /> WOHK AUTHORIZED BV THIS PERMIT MUST BE 5TARTED WITHIN 180 DAYS OF DATE PEpMIT I ISSUED AND 7HE FfER IS TO BE DILIGENTLV PURSUED TO <br /> COMPIETION.THIS PERMIT MAV BE CANCELLED BY THE CITY UPON ANV STOPPAGE OF WORK ON THIS PROJECT OVEii 9Q DAVS DURATION. <br />