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x. <br /> S1 <br /> Date $/23/94 �a � ,�StING ���-�'�/ Pubhc�VO�kiPqimd• 3�� <br /> �C:� � .-----------�� eiae o�o� . . 4537�-- <br /> Application For n <br /> PUBLIC WORKS PE�MIT P°"°°,Y���sF�e — <br /> 0 <br /> ro„�F�e s <br /> p LnsS<001.Frr V,�i� S _ <br /> (� <br /> Print or Type Only � $ � g 8 6' v�i o � . , o��, s _ <br /> W O N J O O �O p� o [� 1f7 �Y • <br /> CJ rN� e'-ii rl .�-J1 � � N �W �t l� C- <br /> � C� M M � F? M � N <br /> Loren Dorrah PO SOX 5036 Lynnwood ,Q80 �78-0555 �m <br /> Owner �^:ailing p�:dress � �,a C�tc a at ca � •-� � Pl�enc <br /> ti O W � O d V � U O O 3 N O W <br /> Curt Johnson 337-4733 0 � � � � a = � � � � � � � � <br /> qpplicant M.;ilin.^,Addrnss Gtv ZiP PhonP -�_-�� <br /> Descrihe Proposed work New d�lex=BASIC 203_________ _ __ _ <br /> Prolect.4ddress Iil known; ���� t-�l1C�'�Q��—��-S-P-•-27-Q� � <br /> � <br /> Nltaeh fOur(4) coP�es of plans toi proVosed worn � Drar: tn .ral.. .in�i nole ihe'otlowmg as anPLcabie�. � <br /> • Properly Lines • C�ar,terline �f street /^ <br /> • Outline and dimensions of all existin9 �nd • Indical�a Norih �� <br /> proposed structures on tl+e lot • Show any r.r000sed giad�nq ch3nges <br /> • Existina and proposed utilities • Show m�.�surements � <br /> DO NOT WRITE EiLLO�V THIS LINE O <br /> PERMIT CONDiTIONS <br /> 1.All calis tor insper.tion shall be made 24 hrs.in advance-phone 259•8810. � <br /> . 2.All work shall be pertormed in accordance with this permit and curreat City of Everett Desi�n and Construclion <br /> Standards end Specifications. <br /> 3.Call Location Underground Service 4f3 hrs.before you dig.TOLL FREE NUMBER 1-800•424-5555. <br /> 4. Rooftop drainage shall be discharged: � <br /> • To the site's storm drain system (private or public) Q <br /> • To a residential roof dow�nspout syste•n designed per section 4- <br /> 9.4 of the city standards � <br /> • Onto splash Ulocks /A <br /> The method selected will be subject to Public Works Ueparter .t V� <br /> approv�l. O <br /> � r i''lal►�t-�.11�1 ZD `G��^' � `���'9�`� ��1/ a <br /> � _,fi/lO7f'- )�(ry /C�� • �-���KNOWLEDG[�,�ENT OF CONDITIONS <br /> ���`��' � // <br /> 7he und�ac�aned owneUauphcant hcreby agrees to hold anC sace harm- <br /> — ---"�" "-" ---�� less the C�ry ot cverett trom any and all ctaims for damages. cosls. <br /> /� //�y�,�, e*penses. or causes ol action Ihat may anse betause of Inslallation <br /> � //��, �i� �� and mau�tenance n! ihe improvement or other right-of�way use here�o <br /> L�,/ . I �;,pl�ed �o� and luriher aqrees to remove same upon notice Irom ihe <br /> Approved for Constr t- �='�<' � C��tc nnc� �o replace puUhc proner;y damaged fhereby. <br /> i I <br /> � -- _�.� - �__j -� , y i3-yY <br /> FINAL INSPECTION ��� - <br /> Approved as Constructed I Si ature uf Applica�n� ate <br /> �N RK AUTHORIZFD BY THIS PERMIT MUST BE STARTED WITHIN <br /> �� PU3L�C WORY.S DEPARTMENT i 90 DAYS OF DAT[ PERI.tIT IS ISSUCD AND TNERE�FTER IS TO <br /> '�� 3200 Cedar Street i BE DILIGENTLY FURSU[D TO COMPLETION THIS PERMIT MAY BE <br /> Everelt,WA 98207 , CANCSLLED BY THE CITY UPON AfJ\'STOPPAGE OF W09K ON THIS <br /> phone:259�8810 I pqpJECT OVER 90 DAYS DURATION. <br />