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TYPE OR PRINT ONLY <br />Owner <br />Applicant <br />Application For " r N�V <br />PUBLIC WORKS PrE V <br />PUBLIC WORKS DEPARTNI <br />3200 Cedar Street <br />Everett, WA 98201 259-81@19 <br />8 <br />Blank PO : <br />Mailing <br />rd�� uio <br />s= <br />CT <br />N O <br />City 0 <br />rr�rt�s�� <br />Z 4 1997 <br />Date 12-26-96 <br />Public Works Permit R (Iz0o <br />Building Permit k 53851 <br />o '^ _ <br />PPal r(po.Vpks Fees <br />N CJa <br />Describe Proposed Work new house ' , n <br />V♦ <br />PROJECT ADDRESS (if known) 6929 Highland Dr Lot 5 SP #14-96 <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the following if applicable: <br />•Property Lines 'Outline and dimensions of all existing and proposed structures on the lot •Existing and proposed utilities O <br />"Centerline of street •Indicate North •Shjw any proposed grading changes •Shnw measurements <br />DO NOT WRITE BELOW THIS LINE <br />PERMIT CONDITIONS: Z <br />1. All calls for inspection shall be made 24 hours in advance - phone 259-8810. O <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and <br />Construction Standards and Specifications. <br />3. Call Location Underground Set vice 48 hrs. before you dig. TOLL FREE NUMBER 1-8W 424-5555. <br />v/ <br />d Install an infiltration trench built as per the city's "Residential RoofDotvnspout System" deatail am O sized as per the city's Table M-3.2 "Roof Dotvn spout System Sizing" stapled to Htis permit The <br />infiltrotion trench shall it , no closer titan 5 feet to ally up slope property line or foundation nor cloy <br />Hall 10 feet to any do«mslope properly line or foundation. Call Public Works for an inspection prio <br />to covering trenches. <br />Date <br />Appro+ed as Constructed <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harmless <br />the City of Everett from any and all claims for damages, costs, expenses, or <br />causes of action that may arise because of installation and maintenance of <br />the improvement or other right-of-way use hereto applied for and further agrees <br />to remove same upon notice from the City and to replace public property <br />damaged th 71y. <br />.,/ 7.�� 1c;971X17 <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PE IT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO <br />COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />