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, Se t•. !0, 1984 �,. ` - ` <br /> ---�— . ��)L/j f/ � L.//�✓/ ' PuLlic Works Permit r f����' _ ."�� ����': <br /> � , Application For oina,oaai.. <br /> PUBLIC WORKS PERMIT Pu�licWo�ksFoe �, � � __ <br /> , � / Total Fes S � � � ' <br /> ��. I:�."�) LessAP�LFeePeltl S -�Y',. -.;. <br /> Print orType Only GRADING & TESCP ;� '' ' � B��a�=ao�< s '� � <br /> Terra Realty & Investment P.O. Box 91 Lynnwood WA 98036 353-6914 <br /> Owner Mailing Address City 2ip Phone <br /> Kegel & Associates 9800 Evergreen Way Everett WA 98204 353-1119 <br /> Applicant Mailing Address City Zip Phone <br /> DescribeProposedWork Aooroximately 15 a 1^ c of th cito ch^11 ha rla rarl nf 11 zbr;� <br /> and rough graded to allow soil to stabilize. Appropriate temporary erosion <br /> control measures shall be taken as required to prevent erosion A total of <br /> 20,200 cubic yards will moved (soil . � <br /> ProjectAddress(;fknoirn) ��ZoO Evergreen Way / � <br /> Attach(our(4) copies of plans for proposed work- Draw to scala and note the lollowing as applicable: � <br /> • Property Lines • Centerline of street � <br /> • Outline and dimensions of all existing and • Indicate North <br /> proposed structures on the lot • Show any proposed grading changes <br /> • Existing and proposed utilities • Show measurement; � <br /> DO NOT WRITE BELOW THIS LIIJE <br /> PERMIT CONDITIONS O <br /> 7. All calls for inspection shall be made 24 hrs. in advance- phone 259•881 5. � <br /> 2. All work shall be performed in accordance with ihis permit and current City oi Everett Design and Construction <br /> Standards and Specifications. <br /> 3. Call I.ocation Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1-800-424-5555. � <br /> �-� �^.�.- i : .-/ , f:i . .; '/ �,� °; . , <br /> , � �� � <br /> � <br /> � <br /> O <br /> _ � <br /> ACKNOV✓LEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm- <br /> less the City of Everett from any and all claims for damages, costs, <br /> / � � exp=nses, or causes ot action ihat may arise because of installation <br /> / //��� -�— � �,, ' and maintenance of ihe improvement or other right•of-way use hereto <br /> �� �'' ��'�1 -'�� `-�� ��� � �� ` �� applied (or and further agrees to remove same upon notice from the <br /> Ap�ed�YorConsiruct Date Ciry and to replace public pwperry damaged thereby. <br /> ��� �� � l� ��s ' -� �y l � <br /> FINAL INSPECTION ' � Date ' <br /> Approved as Constructed � � Signature� Appl'. � ' Dale <br /> everett PUBLIC WORKS OEPARTMENT WORK y1GTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> � 3200CedarStreet 780 DAYS OF DA��E PERMIT IS ISSUED AND TNEREAFTER IS TO <br /> Everelt,WA 98207 BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Phone: 259-8815 CAtJCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> FROJECT OVER 90 DAYS DUIiATION. <br />