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Date 6-26-95 �" f�i!�l��17 �l�i �d �s�f <br />Application For <br />FUBLIC WORKS PERMI ��� i� j9gb <br />Print or Type Only <br />Select 9omes Inc 12811 8th Ave <br />Owner <br />Applicant <br />Mailin�; <br />Msilinq <br />Describe Proposed Work neW ]1ouSe <br />Proiec� Address ��t known! 8828 West Mall Dr <br />. , i=i :_., r � � --, <br />ri �-� r.r �n �.� .., <br />` C� <br />r�=; : [;:.n �.. <br />Ever�tt 98204 513-9006 'r'i <br />��Ciiv ;�; ��; �-; � _Tc <br />. r r. - r'-i i:`. ; <br />Ci r � I... <br />� c� i i i: �� �: <br />p_ _' ii i __. �. r _, _. <br />_, - <br />Ci1V ?iP <br />PUGLc YlarFs Pnrmil a _/��_�L__ .. <br />am� o�p� = 48763 <br />PuLi¢ Works Fec -- <br />Toial Fne u <br />Less ApO�� Fee PaiU $ <br />a5i����o�c s �J'— <br />.�i . <br />p: -S fJ <br />p � :,, In <br />. `, <br />�.��'.,.': Phnnc <br />� - <br />n rl i;j <br />fii i.. . <br />Lot 19 Arbor Glen <br />Attach four 141 eoP�es of Plans for proPused worK - Drav: ta ,c,�i:, an i note th�� follu�.vinq a= .:ppl�r.able: <br />• Properry Lines <br />• Outline and dimensions ol all existing and <br />proposed siructures on the lot <br />• Existino and proposed utilities <br />• Cian!erline nf street <br />• In�ical_ Nor�h <br />• $how any rroposed gratlmg changes <br />• Shnw measurements <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hrs. in advance • phone 259-8810. <br />2. All work shall be periormed in accordance with this permit and current City oF Everetl Design and Construction <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800•424•5555. <br />4. Kcep city sUeets clean at :�i times. <br />.5. Curb gutter and ;idewalk u� tha piat :uz netv ;md undsma��d, a�ry damage ihereto shall h� r;placed at the. <br />discretion of lhe Public Works Inspector. <br />G. NtV chenee in Ihe eitiveway cui mus[ be approved bV lhe Pu' luspector, widlh al prop liue Wiuted to <br />e.ristuig ;ipron widlh. <br />?• Adjust waror boxes to erode at end of cnns�n�ction. <br />�. llm�eway. sh;ill Ue cumpictcty cived b�for� dti�irig on them. <br />9. I:ooRop drainage shall be disch:uged to ihe storrn drain;i�c ;tuL pro��id�+d at the tiont of lhe IoL NO'I'L: <br />bts 1;%-? 7 sis�l not dischare.e drive�v;ry sucUor yard drauiage to Uie stonu di.�uia�e stub, these lots sh�ll us <br />thc sh�b for roof-top drainage otdy. ' <br />���/�s� <br />_����� � r - <br />Approve c ConsVuct� n ,A Date <br />RINAL NSPECTION �?'`5?'o��L� � <br />Approvetl as Constructed r� ��� <br />����PUBLIC WORKS DEPNRTMENT <br />3200 CeJar 5;reet <br />Everett, WA 98?01 <br />Phone:259•881C <br />ACKNOWLEDG[MENT OF CONDITIONS <br />� <br />O <br />i <br />V/ <br />� <br />a <br />The undersiqned owner/applicant hcreby agrees to hold and sae�e harm- <br />less the City ol Everetl Irom any and all claims lor damae�es, costs. <br />expenses. or causes of action that may arise because ul installation <br />anA m�mtenance o! the improvement or other nght-of-way use hereto <br />aPN�ed for and furiher agrees to remove szme upon notice Irom lhe <br />Cdy ,vid to re lace public preperty damaged thereby. <br />' l.0 .i—v 1 � ��/Z � <br />Si9natwe of Applicant ate <br />WC�;( AUTHORIZED BY THIS PEriMIT MUST BE STARTED WITHIN <br />lA0 DAYS OF DATE PERIsIT IS ISSUED AND THEREAFTER IS 70 <br />BE DILIGENTI.Y PURSUED TO COMPLETION. THIS PERIv11T MAY BE <br />CANCELLED 6Y THE CITY UPON FNY STOPPAGE OF VJORK ON THIS <br />PRO,IECT OVER 90 DAYS DURATION. <br />