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Date__6=27-95 <br />Application For <br />PUBLIC WORKS <br />Print or Type Only <br />Select <br />Owner <br />Applicant <br />�\1a�iim:; <br />�'(1 PA��'�'Riu�; ��JPi �� 1998 <br />a <br />��RMIT <br />P <br />� C p <br />T C� l� CG'i ICfi � O r r� fj G <br />Ot m P- O�il� O If) C C G P <br />�:r o �- ¢; M r.; o --- i; c <br />.,a .F. ,F. «� ._ , ;r :�. ... a <br />�.-��� .�1- y ..F eA d _ ii f',: <br />Pf,,�lin;; Address <br />Describe Proposed Wo�k n2W hDUSO. <br />r role:t Address lif known; 8QJ,5_S'12&S�fall_DT__— <br />f'ci�Z.u) r.' 1'� fi 4� �^� <br />f7 f'> S. ]:�. 7� 1 O W G �-� <br />C! u' LJ C� �-' G�- O 3 rr; O <br />_i _i w,;� � o c n i,� <br />a� n. z m c a=3 ac v� ui m <br />anni�cwo�xca��mn< ���J� � <br />oina ora� = 48754 J— <br />PJbI¢ 1YO�k5 F'C 5 <br />TOITI LfP <br />LeSS Qppl FCe Pn',O 'S �/f/�f - <br />Pal,m i�Ci.i. �u `�� <br />Zip Phonn <br />A�tach �our (4! eopies ot d���5 io� P�oposed wurk - Drav: In .r.al.� an7 ncle tlia !o�lcwing as aoG6r.aoie <br />• P�operty Line; <br />• Outline and Aimensions ol al� exisLng and <br />proposed structures on Ihe lo� <br />• Exie�ing and proposed utilities <br />• Cian!nrline nf StrE�et <br />• Intlica�e Narih <br />• �hem• �ny rroposed gradin9 r,hanucs <br />e Shov+m.easu�emen(s <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 peAormed in accordance with this permit and current City of Everett Desiyn 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. Kecp city streets clean al. all titnes. <br />5. Curb gutter and side�valk in the plat are ne�v and undamabed, atry damage tliereto ,hall be replaceJ at tha <br />discrelion of ihe PubGc Works ;nspector. <br />6. Nrv ch�u�ge in Ih� eltivewsy cut must be approvrJ by tbe FW L�speclor, widlh at prop linc limited to <br />eristir� apron widlL. <br />7. Adjusf water boxes to grsde at end of construcdon. <br />3. D�iveways shall be completeh� cured before driving on thern. ! <br />9. Rooflop dr�w�age shall be discharged to the stomi drainage slnb pro��ded �t Qtc front ol�lhe lot. NO'PE: <br />bts 1'7-27 sha11 not disch:u'ge driveway andlor �°ard dr�inage to the stomi drainaSc stub, these lots sh,ill use <br />ihe stub Por roof-top drainage otily. <br />� � <br />FINAL INSP�CTION <br />Approved as Constructed <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everetl, WA 98201 <br />Phone:259-BB70 <br />ACKNOWLE�G[MENT OF CONDITIONS <br />W <br />F- <br />N <br />� <br />O <br />'ihe under�inned owner/apphcant hereb� agrees to hold and save harm- <br />iess the C�ty of Everett hom any and 211 claims for damac�es, r,osts. <br />expenses. or rauses o� ar.tion �nai may anse 6ecause of installalion <br />anq mainten�nr.e o! thc �mprovement or other right-obway use herelo <br />,a,^.ph��; fer and further a9rCe5 to remove same upon notice hOm ihe <br />C.!c ir.A ;o reploce oubhc pronerry damaged thereby. <br />����1%e�� �-aa-y� <br />Signalwe of Aaplican! Date <br />4VORK AUTHORI2ED BY'iFIIS PERMIT MUST BE STARTED WITHIN <br />190 DA'fS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE OILIGEy1LY PURSUED TC COMPLETION. THIS PERMIT MAY BE <br />CANCEI �ED BY THE i:ITY UFON ANY STOPPAGE OF WOFK ON Tf IIS <br />PRQIECT OVER 90 DAVS CURATION. <br />