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Date 12-14-43 <br />Applica�ion For <br />PUBLIC WORKS <br />Print or Type Only <br />u <br />u <br />Sup <br />�� f'OSTING �� <br />o� <br />� <br />PERII�IT <br />S <br />Alderwood Custom Homes 3106 79th Ave <br />Owner <br />Owner <br />Applicant <br />Describe Proposed Work <br />Mailing Address <br />Mailing Address <br />new house <br />Project Address �if known) 6018 <br />r �i�igov�iga <br />.¢y d� [`� CJ O�t O CJ <br />':: v�i«�iwu"'tl r' <br />� u� ". <br />ett 9820� 3 <br />S'��°�cv�i� <br />3id��m�� <br />City Zip <br />Puplic Works Perml� + �� I � <br />aiae-oeo��• 42995 <br />PublicWorksFea $ <br />To�al Fee <br />Less Aool. Fee Pa�id $ <br />ti <br />Oue � ��— <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the following as applica6le: <br />• Property Lines • Centerline of street <br />• Outline and dimensions of all existing and • Indicate Nor�h <br />proposed sti�ucWres on the lot • Show any proposed grading changes <br />• Existing and propused utilities • Show measurements <br />PERMIT CONDITIONS <br />1. All calis tor inspection shall be made 24 hrs. in advance • phone 259-8810. <br />2. All work shall be pertonned in accordance with lhis permit and current City of Everett Design and Conslruction <br />Standards and Specifications. <br />3. C II oCalion Un e ound Se e 48 hrs. be or o d' . TO L FR E N MB 1• 0 4- 5. <br />�. �7nvew�ay s�aibe pave��rom proper�y �ir%io �e e�dge s�pav�mer�t�n t�e Rg��of <br />5. Downspouts shal be connected lo side sewer. <br />�� <br />for <br />Date <br />L �� /-��• rs <br />FINAL INSP �TION Date <br />Approved as ConstructeJ <br />PU�LIC WORKS DEPARTME�'T <br />3200 Cedar Sireel <br />Evereit, WA 98207 <br />Phone: 259�8870 <br />PCKNOWLEDGEMENT OF CONDITIONS <br />W <br />� <br />� <br />� <br />The undersigned owner/app�?cant hereby agrees to hold and save harm- <br />less the Cily of Everett irom any and all claims for damages, costs, <br />expenses, or causes of adion that may arise because of installation <br />and maintenance of the improver�ent or olher tight•ohway use hereto <br />applied for nd further agrees to remove same upon notice trom the <br />City and o r place public property damagr.d thereby. �+ <br />._. <br />__9_�� 4—t— <br />Siqnalure of Applicant Date <br />V��HK AUTHORIZED BY THIS PERMIT MUST BF STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSIIED :+iJu THEREAFTER IS TO <br />BE �ILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WOFK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />