Laserfiche WebLink
Date 6—�7-95 �� ������� <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />�UG d 91996 �s 3z-¢ <br />Puh�m YJatkS Pnrmil a � <br />cin�� o�o� , _ 4�0 _ <br />PULOc 1VorMs Fr.a <br />Totnl Fee 5 <br />Lcss 4pul GRe Pdc! ' ___ <br />e.,i.,��,. r„, S _C-f'J_ <br />Select Homes Inc 12811 8th Ave W IiA-201 Everett 98204 513-9006 <br />Owner <br />Owner <br />Applitent <br />Describa. Proposed Work <br />Prolt^•� Address Iif knowm <br />i�^a�f�rv, nrtdross <br />P.':,�h,�:� Add�cs; <br />new house <br />8916 West Mall Dr <br />t;r,y <br />C�t: Zip <br />Lot 22 <br />Phr�ne <br />Phonr—__— <br />D"16I96 1:::JFM DOOF��s47� <br />Attach teur (4) �oPies of Plans fo� ;;roP� �.eJ wo�K � �rav: to .c.i�:, .,:•,.:� ncte uia ionu���my as anuiir,aMe: j!cC4 $b0.Q0 <br />• Properly Lines • Cen�erlinr nt street SRCHRr, $!F.$l <br />• Outline and dimensions of au exisLng antl • iedicak• Norih DRIV� �� 6c0.Q� <br />proposed struciures on the tof • �how any rronosed 9rad'qfLFhdRJc� <br />• Exis�ing and proposed utilities • Show meysurements Hl1UUUG6 <br />PERMITCONDITIONS SEW�R S7Q.00 <br />1. All calls (or inspection shall be made 24 hrs. in advance - phone 259-8810. �!'SDFV $12%.OU <br />2. All work shall be performed in accordance wif�.i this permit and current City of Everett Desigtt`�r d'C�onstriici'�n�� <br />StandardsandSpecitications. C�iECH $�SB�,�JO <br />3. Call Location Underground Service 48 hrs. be:Fore you dig. TOLL FREE NUMBER 1-800•424-5555. <br />4. 1{EC(I Clij' S7CCfS C�CBp 3I 3� ll[IlCS. <br />5. C�ub guttcr and sidzwalk in tl�e plat arr, ne�v and wulantaged, any damabe thereto shall be repl�czd at (he <br />discretion oPU�e YubGc Works tiispector. <br />G. AnV �. s'nge in U�e driveway cut musl be approved by ll�e PW Inspector, widtl� at prop Wie Gmited fo <br />e:cst'uig apron width. <br />7. Adjus; water boxes to yade at eod of conshuction. <br />S. Diiveways sl�all be cotupletely cured before driving on Ihe�ri. <br />9. Rooftop drainage shall be discharged to tLe stortn drainage stub pro��ded at lhe front of tlie IoL N01'E: <br />lols 17-�7 shall not aischargc drivewa�• ;uuUor yud dr.tinage to the sto�m drau�age stub, lhese Iots sh;ilt usz <br />�be stub for rooGlop drsinage onty. <br />������ PUBLIC WORKS UEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />Phone: 259•8810 <br />ACKP�OVJLECGE�OEN7 Of� CONDITIONS <br />� <br />0 <br />♦�^ <br />V♦ <br />O <br />a <br />l�i�� �.inAe�r�lqnyd owneNappli:,2nl hereby agree6 �o hold and 9a��e haml- <br />iess :h�� Gty ot Everett lrom any �nd al� c�aims for dama9es. costs <br />e�penses. or causes of ar.tion that may aris= hecause of installntion <br />and maintenance o! the improvement or other righbobway use hereto <br />appi�n,: Ior anA further pqrees to remove samr upon notice Irom the <br />Gtv and to replaca G�bhr, proner,y damaged thercby. <br />�u-- �uf,ii .��1�mco �/(a�� <br />Signature of Applican �e <br />INORIt AUTFIORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION, THIS PERMIT IdAV BE <br />CANCELLEU BY THE CITY UPON AN'! STOPPAGE OF WORK GN 7HIS <br />PqO.IEGT OVER 90 DAYS DURATION. <br />