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� qpPlice�ionFor u 7/3/96 � <br /> PUBLIC WOF�KS PERMIT °a`8 - <br /> � O T ��UBLIC WORKS DEPAIiTMEN�ii Public Works Permit M _ � �� — <br /> 1 0 ST I N G -------'—"' 3200 Cedar Street � <br /> Everett,WA98201 259-881� 8uilding Permit% $2191 <br /> 8 Q p p p p p p <br /> � 1� r] O Vi O :`� f.�'.t p ,C.'� �a q �..r <br /> TYPE OR PRINT ONLY �ti c'� '-' �' �' `� "���°p�.��$ w <br /> ("I In O� aR CJ H L�' .�a <br /> �•I M M � M .F � W C•1 � <br /> BORSETfl CUSTOM HOMES 1231 STATE AVE'"MABYSVILLE 98270 653*�3720 <br /> p,,�� MailingAddress � �ity L� = � S� �ZiF �W Wo y�. Phone t`' <br /> � � O:� GJU \ 7_ � 34] W LJ� <br /> � aSiS.' � � � 3 � � Tn � <br /> Appiican: <br /> Mailing Address City Zip Phone <br /> NEW HOUSE � <br /> pesc�be Proposed Work <br /> � <br /> ��/� <br /> V♦ <br /> PROJECTADDRESS('rfknown) 103 nLDER ST ior 19 PARKSTTIF FAST � <br /> qttac�four(4)copies oi plans ta proposed work-Drew to scale and note the following'rf applicahle: O_ <br /> Y�oparty Lines �Outline and dimensions of all existing and proposed structures on the lot •Existing and proposed utilities <br /> �Centerline of street Nndicate North 5how any proposed 9�ding changes 'Show measurements ^ <br /> / <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS: <br /> 1.PJI calls for inspection shall be made 24 hours in advance-phone 259-8810. O <br /> 2.All work shall be performed in accordance with this permit and current City of Everett Design and <br /> Construction Standards ard Specifications. � <br /> 3.Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-4245555. <br /> V♦ <br /> 4. Keep city streets ci�n at all times. O <br /> 5. Curb gutter end ddewalk in the plet ero new and undamsged, anp damege therot � <br /> �ha11 be replaced xt the di�cretion of the Public Worlu Iaspector. <br /> 6. My chenqe in the dHvemsy cut mud be appmved by the Public Worke Inapectoe, <br /> wldth �t prop line limited to e��ting eproa wldth <br /> 7. AdJud water boses to�rade at ead of construcdon. <br /> g, privew�ys�tull be compietely cured before driving oa them. <br /> 9. Rooftop dnin�ge �ha11 be di�eha*�ed to the lota inflltretion treach as per the city's <br /> 'ReddenHal Roof Down�pout 9y�tem" dehil end ss per the locetion iaformaHow on <br /> the lot's dte phn. My change ln the 1ntiltraUon trench must be approved by the � <br /> Public Works Ins�wctor. Call for iaspection prior to covedng. <br /> � ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby egrees to hold and save hartnless <br /> G / the Ctty of Everett irom any arM all claims for damages,costs,expenses,w <br /> � causes of action that may arise because of instatlation and maintenance of <br /> ved for Con,ruction Date the improvement or other right-of'way use hereto applied for and luhher egrees <br /> . i to remove same upon notice Vom the Cfty and to replace public proPeAY <br /> `. ;� :j -.2 ?�'/�7 damaged thereby. <br /> ,// ..��_.. <br /> <� <br /> FI INSPECTION Date . <br /> Approved as Construete�l <br /> Sig � ot ApPli an ��� <br /> �"CpMpLEfl�O RTtiiS PERMIT MAVRBE CANCE BLED BYTTHE OfTYIUPON ANY STOPPAGE OF WORK ON TFIIS PROJEC OVER 90 DA SEWL�TwN v PURSUED TO <br />