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ii � <br /> '� 3Date $/23/94 ?? PubhcYloiFSPe�mit• �� � <br /> "'' �°^�'�ING -24� 45371 <br /> App!ication For n: v o V J oina neP�.. <br /> PUBLIC WORKS P�MIT P�����'<<v0�M5Fee - <br /> ,e„�Fr� s <br /> pLess/oUl.Fr.e Pain $ <br /> C� Z�� <br /> Print or T��pe On�y � `a' o o � � � $ � g �'�_"��� � <br /> c� ri r•i � oo ,uc orvi � <br /> M w .~-1 .�-i ti A M a nM d l� N <br /> .�+ ni M <br /> Loren Durrah PO Box 5036 Lyn�oo� 9�p46� N 778-0�5 ~ � <br /> OwnPr A1a6iny ACdress M O U � �CJ�`2 2 � O�''� U Phonc — <br /> .-i O W O � G] :..l � t.] �"� 03N O W <br /> Curt Johnson 337-4733 $ � d � � a � � `�' � � `� `!' � �"' <br /> qpplican, M:;��hna�ddress .—_— Gtv ZiP Phone —___ <br /> Describe Proposed Work __New du�lex__=__BASIC 203 _ _ <br /> , ���_c:.l��V±���S.nt_2—S.E. 2Z�92 � <br /> Prolect Address�if knov��, H <br /> Attach four(4) coPies ol plans loi proP�Sed wn:k � ��ae: to ;c,iie antl note ii�e follcwmg a;anulicab�e: � <br /> • Property Lines • Conteriine of sireet � <br /> • Outline and dimensions ol all ezishng and • InAic�te North <br /> proposed slructures on ihe lot • Show any r.roposed qratling changes <br /> • Existing and proposed utilities • Show measuremenis /M <br /> W <br /> �� C�O NOT WRITE BELOW iH15 LIfJE <br /> PERMIT CONDITIONS O <br /> 1.All calls for inspection shall be m;ie 24 hrs.in advance-phone 259•8810. � <br /> 2.All work shell be peAormed in accordance with ihis permit and current City of Everett Design and Conslruction <br /> Standards and Specifications. <br /> 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1•800�424•5555. � <br /> 4. RooBop drainage shall be discharged: <br /> • To the site's storm drain �ystem (private or public) O <br /> • To a re ndentiai roof downspout system designed per seclion 4- <br /> 9.4 of the city standards � <br /> • Onto splash blocks � <br /> The method selected will be subject to Public Works Departement � <br /> approval. <br /> � YI'����f�c;l� Z 0 ' G I e�r- -��� o-F c�a ra� dmo�' <br /> a <br /> -�-0 2�sem-evk. -�' Park.M9 r�j��"`a,n<t-S <br /> AGKNOWLEDGEMENT OF CONDITIONS <br /> 1 hr�under�iqned owne�;apPlic.nt hereby 3grees to hold and save harm� <br /> —, inss thu Crty of Everelt Irom any and all claims lor damages. costs. <br /> /� /� i rapenses. or cau5es o� aclion ihat may arise because of msiallation <br /> � (/ /�/// j and mamtenance nf tne improvement or othe� nghbo4way use here�o <br /> ,tAX / / / -� � a;;N:nd �nr and lurther a9rees to remove same upon notice �rom the <br /> Approved fpr Con r ion �^��� � C�:� ����d �n replaca Uublic pro�erty J�maged thereby. <br /> ���� - /.7-.1 7 - `+'�/_ � <br /> FINAL INSPECTION D.te I _ � � /�� Y <br /> Approved as Constructed i_� . we of Apphcan! Date <br /> 1N AUTHORIZED BY THIS PERMIT MUST BE ST�RTED WITHIN <br /> ���� PUBLIC WORKS DEPARTMENT 18 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200 Cedar Street 8E DILIGENTLV PURSUED TO COMPLETION. THIS PERMIT tdAY BE <br /> Everetl,WA 98207 CANCELLED BY THE CITV UPON ANY STOPPAGE OP WORK ON THIS <br /> Phone:259�8870 PROJECT OVER 90 DAYS DURATION. <br />