120 FOREST CT 2016-01-01 MF Import

� uSr. / Application For yy � PUBLIC WORKS PERMIT Date 12-z�-9s PUBLIC WORKS DEP�MENT Public Works Pertnit 8 � _ 3200 Cedar Stre� Everett,WA 98201 $9-8810 Building Pertnit# 50374 To ��TlN6MAY 0 1 � e � � � M g � � N �/�— TYPE OR PRINT ONLY r� o; � o o r,; �nPubl�W�s Fee$�/v �} .aG `� � NN �7 L� T �O (� M N �.-1 eR CJ Yi Duane Landsverk 230 174th St ��rT �$thell WA 980�M 2-�9� \ Owner Mailin�Address p. � o City � � Phone N � � � o � � � � � � � � � i owner � � -� � $ ' Applicant MailingAd�ress City Zip Phone Describe Proposed Work new houae � � ��/� �-� V♦ PROJECT ADDRESS(if known) 120 Forest Court � � � Attach tour(4)copies ot plans for proposed work-Draw to scale and note the following it applicable: o •Property Lines 'Outline and dimensions of all existing and proposed structures on the lot •Existing and proposed utilities 'Centerline ot street •Indicate North •Show any proposed grading changes •Show measurements � DO NOT WRITE BELOW THIS LINE PERMIT CONDITIONS: Z 1.All calls for inspection shall be made 24 hours in advance-phone 259-8810. O 2.All work shall be pertormed in accordance with this permit and current City of Everett Design and Construction Standards and Specifications. 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � �// 4. Keep city ctreetr clean xt all timea: O 5. Curb gutter end ddewallc in the p(at are new end uadamaQed, eny dems�e tharet �hwll be replaced rt the di�reHon of the Publle Works inspector. a 6. Any change in the drivewaq cut mu�t be epproved by the Publlc Works Inspector wldth at prop lina llmited to esiding Apron widt;� 7. Adjust water boxes to 4rnde et end of coa�tructi�n. 8. priveways shall be compietely cured before driviag oa them. 9. Rooftnp drsine�e ahell be dlrcher�ed as followa: a) I.ots i theu 10 �h�il dl�harge to �pl�sh blooks or other approved devioe U) 4ots 11 thru 1 S �hall diacharg to the storm dnin rtub provlded at the front of the tot. �� ACKNOWLEDGEMENT OF CONDITIONS �^ �� The unders(gned owneNapplicant hereby agrees to hold and save hartnless G the City oi Everett from any and all claims for d s,costs,expenses,or Ap e or ruction Date causes of aclio t may arise becau nstall ' n and maintenance of theimprove t otherright-oi-w seheret pliedforandfurtheragrees to remov m upon notice m the C' nd to replace public property , ��,� dama the y. � — FINAL INSPECTION Date Approved as Constructed ; gnature of pli nt _.. Date WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIJ I•SSUED AND THEREAFfER IS TO BE DILlGENTLY PURSUED TO COMPLEf10N.THIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANY STOPPAGE OF'RORK ON THIS PROJECT OVER 90 DAYS DURATION.