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� pPPlication For __ <br /> PUBLIC WORK� PERMIT �a1e— Z�1(96 <br /> PUBLIC WORKS DEPARTMENT Public Works Permit# O <br /> 3200 Cedar Street <br /> Everett,WA 98201 259-B���Y p 2 �996 Buildinq PermN N <br /> �'`� ��ST�N� ������� publicWorkSFee$ �� - <br /> TYPE OR PRINT ONLY <br /> 6AENZ HOMES INC 9004 44TH AVE W MUKILTEO 98275 347-6484 phone i � <br /> Owner Mailing Address ���Y Z�P '1 .,� <br /> \ <br /> DORLIN GAF.NZ phone • <br /> Applicant <br /> Mailing Address City z�P <br /> pe�cribe Proposed Work NE�d HOUSE - BASIC 1163 �` � � 1 <br /> �i�9,'46 3:!�E•f`,'! 0�10G;k,: � r <br /> !1�0050?5? � <br /> a+ r:r, ^^ � <br /> �.G g�'7,i r <br /> PROJECT ADDRESS(if known) 1z' A`�- �� s�z� LOT 7 SID • , � <br /> SRCNRG �:,�D <br /> Attach four(4)copies oi plans for proposed work-Draw lo scale and note the following if applicable: ��,J�J ,i� r.�e � � <br /> •Property Lines 'Outline and dimensions of all existing and proposed structures on the lot •6cisting and p tilities � <br /> �i� °s'.3r <br /> �Centerline ot street •Indicate North 5how any proposed grading changes •Show meas�rements #40008&=6 ' <br /> DO NOT WRITE BELOW THIS LINE ���,�J�_ ' "'' � <br /> PERMITCONDITIONS: cE„�,n, q.p_!t{+ <br /> 1.All calls for inspection shall be made 24 hours in advance-phone 259-881 Q• , ��� O <br /> 2.All work shall be performed in accordance with this�ermit and current City of rf��J�be$195� �" <br /> Construction Standards and Specifications. ' ` � <br /> 3.Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555• <br /> V♦ <br /> 4. Keep city atreeta clean at all times. O <br /> 5. Gurb gutter and ddewelk in the p1aY are new and nndamagad, eny damage theret � <br /> �hall be replaced at the discretioa of tLe Public Worlcs In�pector. <br /> 6. Anp change in the drivewey cut muat be approved by the Public Works ln�pector <br /> width at peop line limited to existing epwn wlldth <br /> 7. Adjust water boaes to �rsde st end of constructlon. <br /> g, Drivevw�ye�t►�ll be completely cured before driving on them. <br /> 9. RooRap dralnage ehell be dlscharged to the lots iafiltration trench as per the city's <br /> "ReadenNal Roof Downspout System" detail and as per the IocnHon informetion nn <br /> the lot's site plen. Auy change in the insYiltraHon trench must be epproved by tha <br /> Public Wor4s t�nspector. Call for inrpection prior to covering. <br /> � ACKNOWLEDGEME�T OF CONDITIONS <br /> ^/r�� The untlersignetl ownedapplicant hereby agrees to hold anC save hArmless <br /> JA S�f�/A� the Ci4y ot Everett fro�ri any and all claims for damages,costs.ezpenses,or <br /> r�� �0 '1�GYT causes of action that may arise because of installation and maintenanc:>of <br /> qpp�roved tor ConstrucLon ate the improvement or other right-ot-way us�here[o app�ied for and further agrees <br /> i <br /> � to 2move same upon notice from the City antl to replace public property <br /> ���� . - -/3V �/ damaged thereby. <br /> . . . �_ 7' • �. <br /> FINAL INSPECTION Date ^����a�Q /� . <br /> qpprrned as Construaed � W w �019 � <br /> L� Date <br /> Signature f plicant �j <br /> COMPLETION.TIHIS ERMIT MAY BE CANCE B ED BY THE CITVIUPON ANY SOTOPPAGE OF WORK ON THIS PRO EC OVER 90 DAVSEDUR'ATEONLY PURSUED TO <br />