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JJ ' <br /> :4 <br /> � APPlication For :i. <br /> PUBLIC WORKS PERMIT �a�e 12-13-95 <br /> PUBLIC WORKS DEPARTMENT��� Public Works Permit# `I J,S� <br /> 3200 Cedar Street s�� <br /> E��erett,WA 98201 259-8810� Q <br /> €� B�Ilding Permit# �'� rJ���'V <br /> NOV 2 6 0 � c. .-; G <br /> TYPEORPRINTONLY �p pQSTING �y96 r � � n u� r' �'� �' r• `�' °�� <br /> '�—_ u� m vi o �:� o ��blic�rks�e$-e., <br /> ���i m o ,u M� n� •fi c� r� rn � <br /> Y, H� �� ..h e} .�: b� Sd I': <br /> D.I. Homes 21127 State Rt 9 SE Woodinvil�g 98072 481-$,�85� Stev'e Harris <br /> �'^e� Mailing Address a.� � ry �� -.. �i ,, o -> Phone O <br /> \ U3 r.' 3G.ttly� N? Cr.. LJ �' � <br /> O� C G�l L'l �' 1 � G] W I'J l�J [l�) W <br /> Owner �� rc? 4� c; c� �< ;� or- n -; <br /> � o �i � e� - ' k _� n ¢ r� G ; i <br /> :+c � u � yn_ a � r. ui� . 7 <br /> Applicant Mailing Address City Zip Phone <br /> Descr.be Froposed Work new house � <br /> _�_ � <br /> � <br /> PROJ'cCT ADDRESS(if known) 116 Forest Court Lot 7 S innaker Pninte � <br /> Attach four(4)copie�s of plans for proposed work-Drew to scale and note the folluwing if applicable: � <br /> ` perty Lines 'Outllne and dimensions of all existing and proposed structures on the lot Exfstin and ro O� <br /> � g p posed utilities <br /> 'Centerline of street •Indicate Norlh •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 pertormed in accordance with this permit and current City of Everett Design and O <br /> Construction Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � <br /> 4. Keep city �treets clean at aU times. � <br /> 5. Curb gutte,r snd ddewelk in the plat aro naw and undutuged, enq d�maje theeet O <br /> duU be replaaed At the dl�cretion of the Public Works Inspector. � <br /> 6• My chen�e in the drlvewuy cut mu�t be approved by the Publlc Works Inspector, <br /> width wt prop line limited to ead�ting apron wldth <br /> �. Adjust weter boaes to Qrade at ead of construction. <br /> 8• (hivevwiys s6�1! be vomp�etely oured before driviag on them. <br /> 9. Rooftop dreina�e �ha11 be di�chu�ed as followa: <br /> e) Lots I thru 10 �he11 disharga to spia�h bloats or other �pproved devioe <br /> b) Lots 11 thru 18 �hall dI�char� to the �orm dnin �tub provided et the <br /> front of the lot. <br /> I a• K�l�ce cac�5���5 G�r.� ��£ w�,Fv I I �'�jht. cv rb -(-��t c .� <br /> ,,�rIJ� "� � s-f�� PI�h #3oc� U�.., D,4� � S-�d � � <br /> IN -3en . <br /> � ACKNOWLEDGEMENT OF CONDITiONS <br /> �� �/JC� � / �/C The un�/dersigned owneda�plica�t hereby agrees to hold and save harmless <br /> /// Z Z � the Ci of Evarett from an and all claims for damages,costs,expenses,or <br /> �roved for C9AslrucUon p e causes of action that may arise because of installation and maintenance of <br /> _�j � theimprovementorotherright-of-wayuseheratoappliedforandfurtheragrees <br /> �� to remove same upon notice from the City and to replace public property <br /> � �,:._ �/ -6 ,� damaged thereby. <br /> FINAL INSPECTION Date <br /> Approved as Constructed <br /> � <br /> Signature of plicant Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THER TO BE DILIGENTLY PURSUED TC <br /> COMPLEfION.THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />