Laserfiche WebLink
� <br />� <br />Date 5/26/95 <br />�::: 5- (v-Z��S' <br />Application For � � <br />PUBLIC WORKS�E��� g�2�-qs <br />O <br />Print or Type Only ¢ 53 0 0$ v3 � <br />in o u.c.�i o.s+�o <br />tn a .n ."'�a ra�. <br />a� «� <br />Cap All <br />Ar.dress <br />Pupl¢ Wo�ks Perm11 • �� `� .l V / <br />em9 oeo� + 48444 <br />Pubhr. Woruy Fee <br />To1Nl Fpe S <br />Less Aop�� Fen PaiU S <br />9f� D�io .4 7�^ <br />Ie 98292 � �� <br />a <br />���n�u; �x <br />�� ���� <br />Applicant Maihnn Address Citv Zip <br />Deacribe Proposed Work _ NeY house – BeBiC 164 _—_ <br />P�oject Address {d k��cwnl <br />6421 Highland Dr <br />Lot 3 Short Plat <br />AtteCh four (4) copies of plans lor proposed wurk � Draw ta sr.,�ie ann note tha following as applicabie: <br />• Property Lints <br />• Outline and dlmensions ol all eaisting and <br />proposetl struc:u�c> on the lot <br />• Existing and proposed utilities <br />� <br />• Centerline of sireet <br />• Indlcate North <br />• Show any proposed grading changPs <br />• Show measurements <br />PERMIT CONDITIONS <br />1. MI ulls for InspeCtion ehall be mede 24 hrs. In advance - phone 259-8810. <br />2. All work ahsll ba performed in accordance witA this permit and current City of Everett Design and Construction <br />Standarde and SpeclHcatlone. <br />3. Call Location Underqround Service 48 hra before you dig. TOIL FREE NUMBER 1�800�4245555. <br />4. RooBop diainage ahall be diec6arged: <br />• 1'o Ihe oitde etwm rhain ayatem (private or public) <br />• To a reoidentiel roof downepuut eydem designed per aecGon 4-9.d of the <br />city etandards <br />• OMo eplesh blocke <br />1'he medrod selected will be eubject to Public Works Depertement approval. <br />�PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />� Phone:259•8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />� <br />� <br />�J <br />� <br />� <br />O <br />a <br />The imdersiqned owner/apphcant hereby agrees to hold and save harm� <br />less the C�ty o1 Everell Irom any antl all claims for damages. cosls. <br />exPenses. or causes of action that may arise because ot inslallation <br />anA ma�n�ennnr.e of the improvement or other righhof-way use hereto <br />appi��d lor anA lurther agrees to remove same upon notice from the <br />Cdy.�nd to replace pubhc properry damaged thereby. <br />ri„ �'� <br />SignatQre�pplica ^ ate <br />WORK AUTHORIZED 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 MAV BE <br />CAt�CELLED BY THE CITY UPON ANY Sl'OPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />