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/N'�, . <br />�� <br />TYPE OR PRINT ONLY <br />� 6�[i / <br />Owner <br />Describe Proposed Work <br />_: nPvi�cal,onFo�?OSTING A�G <br />PUBLIC WORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />:i: 3200 Ceda� Street <br />�yerett, WA 9tl201 259-8810 <br />'ri <br />or.�r r.,t'� c_ r-��� <br />s_ f- • i r: i v) f'i U. <br />cZ <br />IJ o, a G.-; C_� o c� -. n <br />b1 P: CJ `V «� ( I r � r�: .. r'� <br />�. �a'�%"�: /�r�{):.'� •L�./,9«� .'«�.✓�aJ9i�i., <br />PROJECT ADDRESS (if known) <br />oaa.. LJ C.� � : -� -T. <br />ro [9 :l" L T 4: -r i_� <br />r: J dl CI f t�! Cl F� �, <br />Address <br />q 1991 <br />c� . o i <br />o c�r <br />C. til L� <br />Cr C'1 <br />i <br />IICf �1' <br />Attach lour (4) copies o( plans lor proposed work - Draw to scala and nota the following if applicable: <br />Date ____ /`-/ O `� <br />, -�a- - <br />Public Works Permit q -1 � �� <br />Building Permit k _ ��7�'� <br />A <br />Public Wo�ks Fee $ _.� _ _ <br />Phone <br />•Property Llnes •Outline and dimenslons of all ezisting and proposed stiu�!u�es on �he lot •Existing and proposed utilities <br />•Centerline of sireet •Intlicate North •Show any proposed grading r.hanges •Show measuremenis <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 <br />Construction Standards and Specitications. <br />3. Call Location Underground Service 48 hrs. before you oig. TOLL FREE NUMBER 1-800-424-5555. <br />I Invisill �n mlilirahou trench huilt as per the city,s „I; esidridial kooi'no�ws�ioid System' il-a�s�il sn <br />,ir.ed :�s per ihe cih�'s'1'able Q1-3.2 "Roof Do�v�ispout System Si•r.ine � stapled to this penuit. '17ie <br />iulilh ation 4 eucL s6u11 br uo closar qifm 5 te.zl to a�iy up ;lope prope�iy liva or iow�d�tiou nw clos <br />ihsm 10 fcet lo :uiy do�vnslope property line or toimdation - final location sl��ll bc ficld approved h <br />Pnhlic �Vorks Inpector. Call Poblic \Voii:s �br mi inspection prior to coverine Irenchc5. <br />�. Pravide i'our otTutreet {ot2�eauemunt) psui:inq;talls. <br />G. Lxcav�ded matarial Bom tliis sile shull ba hauled t��vay lo am sy�pruved recaiviu,q �i�e or, witl� Oi�• <br />Public 1Vo�i::; Inspectors prior appro�::d, may be used to fill in lon .v�.Ls on Ih� lnt. Excavated <br />msiten,ll SIIFtII f10C Ilp IIIOUII(Il'(I AO as to creale drain.�ee or rrosion probli mv ou o-uljomiq� propei?iea. <br />J� . FC�Lv ��A.itr�/ S :zU — f % <br />FINAL INSPECTION Date <br />Approved as Constructed <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agraes to hold and save hartnless <br />Ihe City ol Everett Irom any and all claims fcr damages, costs, expenses, or <br />wuses of action that may arise because of InstaGation and malntanance ol <br />tho improvement or other right-of-way use hereto applied for and further agrees <br />to remove samo upon notice from the City and to replace public pmperty <br />damaged thereby. <br />WORK AUTHORI2E0 BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS TO 3E DILIGENTLY PUflSUED TO <br />COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVEfl 90 DAYS DURATION. <br />