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ti <br />puB�ic woRKs <br />PERMIT <br />PUBLIC WORK3DEPARTMENT <br />3200 CeAar Siroat <br />Everott, WA 98201 <br />wzs� 2sp�ea�o <br />. ___. ._ _ _ . . . .__---"--' — <br />OWNEH 1lAME <br />ANDA�ORESS�. }'jj��: [;h'y�j�� 5 ,jll[l� <br />4717 EELVEDEf:E A1'E <br />EVEkE1T WA 9@_03 <br />PHONE qZ5353749.: <br />Date <br />Public Works Permit k <br />BuAAing Permi� k <br />Planning Felerenw W <br />Pubfic Works Feo $ <br />Guarantee S <br />APPLICANT NAME <br />ANDADOPESS�. (�(J}jER <br />PH�NE. <br />�`.�'Si=n�;, <br />F470705-G5B <br />rn7o5-oq' <br />$?�+.i�n <br />1 <br />— _ _ _-- - - --- <br />— --- <br />TAXPAHCELIDM PROJECTA�DRE55 <br />p091710000360__ __ __ --__ _— __ .._---47_1_Q RELVEDEkE AVE------_---- <br />oeccairnoN oF <br />VaOPOSED WONN�. NF:47 HOII$F. <br />!J�'��C� ��, , �_Il _ _ li jc•i<' 2.-.� c.' �7� - 194> - /c-�.'•�J <br />_ _ --r ----- - - --- --- ----- ------ <br />PERMIT CONDI"fIONS <br />L�Yf 36 PLA'" <�F DARLINGTON REPI.AT �'�F <br />LOT X BLAM607-001 <br />1 All calls lor inspection shall be made 24 hours in advance. <br />2. All work ,h211 br. performed in accordance �vith this permit and curron� City ol Everel� Design and Cons!ruction <br />Standards and SNecilica�ions. <br />3. CaU Location Undergrouno Sernce 48 hrs. belore you dig. TOLL FREE NUMBER 1•800•424-5555 <br />_,. rnnn�c+. 3id•. X��wer per rity Standard N's 6p1, ti0�, r,04. <br />''. The �ontractuc must meet v�ih the Fub11C Work� Inspector to di�cu°,s potemual <br />�n.,inage cou[inq pnor to he�7�nning thP pro�ect. <br />. Install er.osion c•nntrol measures s� drtermined hy the Publir WccY,s in�pector, �uch <br />r�ilt fence, otcaW bale9, svales, oe ero�ion hlanketa. <br />. hemove e�o�ion conccel meaau�ea upon completion of the �C0J0Ct pcior te final <br />.�r�.ova1 ��f che pecmit. <br />�a. Ai] esc.,vated mat.Nrial Yrom foundation, sidevalk and drivevays shall be haule�l t�� <br />�n approved, ��Frm�tted aitN. No vaatin� nf mateciai ie all�+.+ed on thie buildinn lot. <br />. No dirt, mud, rocks nr debcia to be tcacked onto coadvay. <br />I�. If a�eWer ��ump ey�tem ie to be instailed, the presauce line mU9Y �19CI13C7P into a <br />��r�vac� manhnle, then �7cavity fluv actoss the puhlic nght-uf-v�y. <br />°��F PI�HLIC WORIcs INSPECTI01:. r_ALL P1+NDY AT 425-3'?-7403 <br />/� . ) �C'IYp G✓rl �t r .� Si�YrJ �� �� //'S lr. ��t'i✓�• y.. �J( !/�'/ _..'�'''�� ����� % <br />�, c. � >;.�� ,� . ��;�y <<>�t �; _�,�� , <br />� ACKNOWLEDGEMENT OF CONDITIONS <br />�� ' � ' The undersignetl ownedapphcanl hereby agrees �o hold and <br />� ��, /` rJ���t' I save harmless the City ol Evorett Irom any and all claims lor <br />� � �7e�v� •- J f-�- I Aamages, tosts, oxpensos, or causes oi action Ihal may arise <br />A�pr� ni Conslnrtlion _ � D o <br />. , , , becau5r ol installalion and mamtenance ol Ihe unprovement or <br />y/i� �' olher nght-obway use �ereto applied for and fudher egrees to <br />//�' �� _`l . C^-�� `�',1 remove same upon no�ice irom Ihx City nnd to �eplace pub6c <br />FINnA�LINSPE��ON p�damage�lhereby. — ` <br />A roved as Consbucled �nto � J\�/ , � % <br />_--__.__._.__ . ._. __.. _.__-_—__.—.-._- ___.I SignatwaulAp{�nl `)`��` l./ ale/� O[ <br />WOqK AUTHORIZED BY T1115 PEIIIdIT IAUSi BE STARTED WIr�IIN 1P0 DAYS OF pp?E PERMIT IS ISSUED AND iHERFAFfER IS TJ BE DI�IGENTLY PURSUE� <br />1�) [;OMPI f_1ION TIIIS PERIAIi IdAI [iC (IANGEI l CD 01'THE CITY UPON ANV 5T01'PAGE Of- WORK ON THIS PHOJE�1 OVER 9U DAVS DURATIQry <br />I�V.Pi �. <br />I nral�nli V6. <br />W <br />� <br />V+ <br />W <br />O <br />� <br />Z <br />O <br />'�w <br />V+ <br />O <br />� <br />