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� <br />� <br />� <br />TYPE OR PRINT ONLY <br />Application Por <br />PUBLIC WORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />z/a�E9e <br />Public Works Pertnit # � �`�' � <br />Everetl, WA 98207 259•8810 � Building Permit k�fl.936 <br />TQ POSTING `�� � 7��6;�Wo,�SFeeg Z�" <br />Ralph Schuck 20717 36th Ave NW Stanwood 98292 652-1309 <br />Owner Mailing Address City Zip Phone <br />Applicant Malling Address City Zip Phone �� <br />Describe Proposed Work <br />PROJECT ADDRESS (if known) �% � <br />New house — Basic 1105 <br />Oi/0'_.!95 10:�ORti <br />H'3Q0504zb <br />JLUJ YJI.J^ 7V <br />� I�C� ��� �C, l� �ac-e P� ss sEs. ro <br />Atlech four (4) copies ot plans for proposed work - Draw lo scale and note the following if applicable: gG'C1',i.� $'+. 50 <br />•Property Lines 'Outline and dimensions of all existing and proposed structures on the lot •Ezisting and prOjSbT1AfJ'Gtilities°^_p, 00 <br />'Centadine of street •Indiceta North •Show any proposed grading changes •Show measurements CHECf: �bb�. SU <br />PERMIT CONDITIONS: <br />1. All calls for i�spection shall be made 24 hours in advance - phone 259-8810. <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 Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. <br />a. Keep city streets de�m ut all mne.s. <br />5. Ciub guuer �nd sidew.�U: in tl�e plat me new and undmuaged, a�ry d:unage tl�ercto sh;ill be repl:iced at tl�e <br />discretion of the Pub6c Works Ins��ector. <br />6. A�ry cha�iFe ui d�e drivewsy cut uwst be approved by lhe PubGc Works L�spettor, width al prop Wie limited� <br />existui� apron widW. D�ivew;ry may taper ��adually to meel ga�•ane door enU;mce (for au approwd 3 c�u <br />R�K�) <br />7. :ldjust water boxes to �ade �t end of consuucUou. <br />S. Division 2 Lots lots 3A,5 � S �t�sll dischargc �ooftop drainage to the lots uifilha6on trcnch as prr the <br />"Dispe�siou Trench Det�il" o�� shecl 5 of lhe Nl�tr to��sUu�4ons pl��s. A���etousll7�clio0 meClu�g must bc <br />�chedulecl �viUi :Uan Locke (3S3 ��655 mob. or 259-3310 o1Tice) prior to installation o( die inliltration sysleui. <br />:1m� clivmc in Uie inlilVation Ueuch tuust be. approved bj� tl�c Public Works Inspedor. Ali o�her Io1s in <br />Ui�rision 2 sh;�l discharge rooftop drninaga to tl�e slom� drain stuU provided to Wa lot. <br />�'/o ,,� �� ���,Z/Z3/y�v <br />Appro or Construction Date� <br />/� <br />� G �" 6 �-s ��� <br />NI� t�ECTI Date <br />Approved as Constructed <br />� <br />O <br />/�� <br />V♦ <br />O <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The underslgned ownar/appllcant hereby agrees to hold and save harmless <br />lhe City of Everett from any and all claims for damages, costs, expenses, or <br />causes of action that may arise because of Installation and malntenance oi <br />the Improvoment or other righbof•way use hereto applied for and further agrees <br />to remove same upon notice from the Cily and to replace public properry <br />damaged thereby. <br />Slgnature Appllcant �� Date <br />WJRK AUTHORIZED BY THIS PERMIT MUST BE STAR'fED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS TO BE DILIGENTLY PURSUED TO <br />COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANY STOF'r".1GE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />