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t - <br /> Date 6-21�-0` <br /> n �����I�� G�irylicl'lO�FSPn��n�iv ��j/F/ 1�. <br /> Applir,ation For � ��r✓ <br /> 1 � <br /> PUE�LIC 1►1/ORMS p��OVIIT ���'��� G�"� �Cp1v 48677 <br /> �'utihC Works Fce --� <br /> iolil C�e $ <br /> —�— <br /> Pflfl� Of T g �ess anu�Fne pa�o S��_ <br /> YP Only <br /> �aianco ooc g_�Q� <br /> �— <br /> Da11y ilomes 3316 Fuhrman Ave E Ste 100 Seattle 9g102 328-3770 <br /> Own �^A : - <br /> iny 4r.�ress <br /> C�ty 7ip <br /> Phonr, <br /> Owner /1) <br /> 1 .C; ' <br /> APPlir,an! �d.,ihnqAddress �—_-----__ • <br /> Cilv ZiP _-- ___ �� <br /> Phnnq <br /> Describe Proposed Wark _n2W houS2 <br /> --�---__—.____ ' —__—_'_'._ <br /> �— <br /> ProJectAtld�esspf knov.�n! ___4031 KTomer_AVe - w <br /> Attach ! -� --- --- -... —._ _ L'�/`E,/96 r.,,i6F�1 .)^��NrF;�� � <br /> Our(4) coPiCs of P�ans loi proPosed n�o�k � Drav: In ,. u�• .v,� nr.te Ih,� 'oqc�vin�as anulirable- � <br /> • Pronerty �inea #�ROOkRG77r T <br /> � Outline and dimensions oi all exishng pnd • Centeri�ne nf strev� � <br /> proposed slruCtureS on the Ior • Inrfir,a�,; North �=��u `«_99,�i1 /� <br /> • Existing and ProPosed u�ilities • ���oa:any r.roposed yratlin`C}�ry��y�,s '�!;�:�Q �� <br /> • Shnwmeasurements !!PT��';J�� <br /> °��.�� <br /> �O NOT WRIiE 6[LOW iHIS LiNE ��nn������ � <br /> PERMITCONDITIONS °1"'T=^� g:.J5�0�7 <br /> 7.All calls for inspec�ion shall be made 24 hrs.in advance-phone 259-8810. 4�0030�'4 }' , � � <br /> 2,All work shall be peAormed in accordance with ihis permit and cur�ent City of Everetl Desi LI" , J <br /> Standards and Specifications. 9r £�i'dConsttu8l(on7i �� <br /> 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1•$00•42�.5555 c <br /> ' 094,,,0 <br /> � b:cep cit��slrects cican at �ll times. �° <br /> 5� Ctvb gutter uid>iriew:dlc in ihe plai are nea�and undam�ged, vry dam�ge ther�to shall be re��laced ;u ihc r_ <br /> discrction of Ihc Public W���;s jris��ector. � <br /> �. Arrv ciiantte in the driveway cut must be :ipproved by the pW Li;p�,ctor, widl.h �I,�rop Gne linuted to <br /> cxis(ing apror widili. � <br /> ' Adjust water boXes to [rade at end of conslniction. <br /> 3. lliivcw:rys shall be complefc!y curcd Uetore dm'ing on ihrin. � <br /> 9� RooYlo� dr;tinare sliall be di�chareed: <br /> � l0 IIiZ SIIC�S SIOI�IU fil8pl Sti:CICIII��I1V3IC pl��111�I11'� � <br /> a <br /> �� ACf(NOWLEDGENENT OF CONDI7� <br /> ON.S' <br /> /� _'_ _" __.' 7h"und.:r:.iqnetl omnpr/�PPlic,nf h�rebY ag�ees lo ho�d antl sa:e h�rrn� <br /> / /� �� � i less ;he Ctly ot cvarelt Irom anv and all <br /> claims Ior damages, cosis <br /> • �i //_� : expense;. or causes ol action that may arise hewuse of ir.;iallayon <br /> Approved for G w/���s i aO� �n��^�enanr,e o! Ihe improvement or other nqhbof�way use here�o <br /> � 9nsiruct n y`— , i ��r.�hed IOr �pf� �urfh(u a� remove same upon notice Irom ihe <br /> � C�!<.i;:ri tn rePtacc publ � Proner,S'damaged thereby. <br /> .�l',��� � - <br /> FINAL INSPECiICN / `— � � �� I � ^ <br /> Approved as Cons�ructed Uate � • % _J <br /> I S gnafwe ol APPhcan! ��- Z-�� <br /> PUBIICWORKSDEPARTMENT i INORK AU7hiORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3<^OOCeCar51ree1 790 DAYS OF DATE PERMIT IS iSSUED qND THEREAFTER IS TO <br /> Evere�t,WAg8201 � 7E DiLIGENTLI' PURSUED TO CC6IPLETION. THIS PERtil1T tdAY BE <br /> Phone:259-8810 '; CA^dCELLED B'/THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> ! PAOJECi OVER g0 DAYS DURA710N. <br />