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� <br /> � � `^4TING ��lDate _ ��� � ;.�� <br /> �/ �' APPlica�ion Fur � . s = . .• — . <br /> !����� PUBLIC WORKS PERI�IIT 3i1r96 ____ <br /> v—'" PUBLIC WORKS DEPARTMENT Public Works Permit M _� � <br /> 3200 Cedar$�reet —��_—_ <br /> Everett,Wq g8201 ���I 259-8810 <br /> ,-, 8uiltling Permit ff.____�_l�� <br /> � c _�. � ... �,. —_ <br /> TYPE OR PRINT ONLY � � P�{b�y�Works Fee$ '�� <br /> t ea .,. � r' trn ' -- __ <br /> Borset❑ Cons[ruction 1241 S te Ave�� u \�� ��, �� �-' <br /> — � J�1ar�*svi�l p� 98270 <br /> Owner Mailing Addiess r, ��� ; <br /> u �Yx c� ,� f; i��P. Phone –� <br /> n 47 f (t (:I I�1 Cl L [ Ci <br /> Tod Borseth 359-1034 i�� #, �;� c' � `� '� ` �`.' ` <br /> �rik `s »r �`; r � �'g °� �' <br /> Applicant Mailing Address City Zi <br /> P Phone <br /> Describe Proposed Work New house �- Basic 1173 <br /> W <br /> N <br /> - <br /> PROJECTADDRESS(if known) 123 Alder St Lot 18 Parkside East � <br /> Attach four(4)copies of plans for proposed work-Draw to scale and note the following if applicable: m <br /> •Property Lines 'Outline and dimensions of all existing and proposed st`uctures on the lot •Existing and proposetl utilities O <br /> 'Centerline of street •Indicate North 'Show any proposed grading changes •Show measurements <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS: � <br /> 1.All calls for inspection shall be made 24 hours in advance- phone 259-8810. <br /> 2. All work shall be performed in accordance with this permit and current City of Everett Design and O <br /> Coristruction Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. <br /> � <br /> 4. Keep citq streets clean at all timsc. � <br /> 5, Curb gutter and ddevuo�Ik in the plet are new and undamaged, any damage theret O <br /> aha11 be repinced �t the di�cretion of tLe Public Works Intpector. � <br /> 6• AnY chenge In the drivewap cut mud be approned by the Pubiic Works In�pector, <br /> width at pwp Iine limited to ealsting apron wldt6 <br /> 7• Adju� weter boues to�rade at end of construction. <br /> g• Dr�vewaYs ahaq be completely cured befora driving on tham. <br /> 9. Roof'top drainage shall be diacharged to the tots tnliltratian trench a6 per the city'a <br /> "Reeidentlal Roof Downspout 8ystem" deta�l and as per the locatlon information on <br /> the IoYs site plsn. My chan�e in the i�ltration trench muat be epproved b� the <br /> Public Works Inspector. Call for inspeaYion prlvr to covering. ` <br /> � <br /> ��� � ACKNOWLEDGEMENTOFCONDITIONS <br /> � The undersigned owner/applicant hereby agrees to hold and save harmless <br /> the City of Everett from any and all claims for damages,costs,expenses,or <br /> Appro ed tor Construction p te causes of action at may arise because of installation and maintenance of <br /> � thei rovement r therright-of-wo;useheretoappliedforandfurthera�rees <br /> to r m v same u n notice from the City and to replace public property <br /> � _ y-�_FL da �q - <br /> FINAL WSPEG ON Date � - <br /> Approved as Constructed �--y <br /> � � <br /> S�g u o ApN can� Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 780 DAYS OF DATE PERMIT IS ISSU D ANU THEREAFTER IS TO BE DILIGENTLV PURSUED TO <br /> COMPLETION.THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANV STOPPAGE OF WORK ON THIS PRQIECT OVER 90 DAi S DURATION. <br /> I <br />