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TYPE OR PRINT �NLY <br />Loren Dorrah <br />Curt Johnson <br />Application For <br />PUBLIC WORKS PERMIT <br />PUBL�C WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 259-8810 <br />���1 �OSTING _�a-S-�� <br />2820B Lincoln <br />Mailing Address <br />337-4733 <br />Mailing qddress <br />Describe Proposed Work new <br />PROJECT ADDRESS (if known) <br />Ave <br />� <br />oate_ 5-20-96 <br />Pubiic Woin; ,^-ertnit # ��/z� 7 <br />—��_ <br />Building pe��� q : ' j ; <br />Public Works Fee $ � � :J <br />98036 787-6700 <br />SP <br />Atlach four (4) copies of plans tor pmposed work - Draw to scale antl note the following if applicable: <br />•Property Lines �p <br />—95 <br />utline and dimensions of all existing and proposed structures on the lot •Existing and I�pbSB�/tl�ilrtfes 04PM <br />•Centerline of street •Indicate North •Show any prtiposed grading changes •Show measuroments <br />-- ---- q00051778 <br />PERMITCONDITIONS: `�`""" ��n"�ot�vW IryISLINE � , <br />1. All calls for inspection shall be made 2�1 hours in advance - phone 259-8g10. �� f154,pp <br />2. All work shall be pertormed in accordarice with this permit and current City of �� Des ��•r� <br />Construction Standards and Specificati�ns. <br />3. Call Location Underground Service 48 hrs, before you dig. TOLL FREE NUM ��1 ��� <br />��-424-5555. <br />41A1ER 5750. pp <br />M00030b36 <br />� F'cep cily sh'ecls clean at all limes. � i70.00 <br />5. Curb guller auJ �idrw;dk iu tLe; plal .ue ucw and wiJ;uua��ed, any d:uua �C St'SDEV SiBBk,00 <br />discre6on oflhe FuL•fic N'orks tnspector. ��%���Il'JY�$��f31'C(I 81 l, <br />n• Am change iu the driveway cu1 musl be approved by the F W inspector. �Ct� 5�50. DO <br />� �ldjus( watcr boxcs to graJe at cnd oP consttuction. <br />4• Privewa�s shall bc completely cured bcfore dm�in� ou them. <br />�. Side sewer and Stom� scwer conuections shall be iustall�d as per Ihe approt•�d consmicfiou piau ior iiie <br />�hoi1 plaf improvemcnts. <br />� <br />O <br />♦�A <br />v♦ <br />O <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and s�ve harmless <br />ihe City of Everett from any and all claims for damages, cosis. expenses, or <br />causes of action that may arise because of inslallation antl maintenance of <br />the improvement or other nghbof•way use hereto applied for and further agrees <br />lo remove same upon notice from the City antl to replace public property <br />damaged thereby. <br />I�y�Y"�vcuaiyVll]IfUGIQ(J I <br />Si9 a6 ture u( � � ���'� <br />pplicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT I ISSUED AND THEREAF7ER IS TO BE DILIGENiLY PURSUED TO <br />COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DUfiATION. <br />