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PtJBLIC WORKS PERMIT <br />City cf Everett PuIQQC Works Dep��er,�g���� <br />3200 Qg��y,Street �,EG-1 <br />Everett, WA 98201 <br />c4z5�����aw���o�� <br />OWNER NAME AND ADDRESS: <br />SHUBINA LYUBOV 8 SHUBIN PAV <br />1919 HOLLOW DALE PL <br />EVERETT WA <br />PNONE: 4253873873 <br />AX PARCEL ID k <br />98204 <br />DESCRIPTION OF PROPOSED WORK: <br />NEW HOUSE <br />i RLPG. <br />Oate: 12/1l2008 <br />Public Works Permit #: PW0812-001 <br />1ti:40 Buildinp Permit #; C0811-011 <br />��aa o y.. <br />'�ninp Reference #: <br />Public Works Fee $: $ 25.00 <br />Other $: <br />�L� APPLi'�Gl� NAME AND ADDRESS: <br />FYC SiG0.0� <br />F��c �sif,o.�u <br />� <br />� �� $�4:°0 ?'0 POSTING oEcr <br />t1LGG. P � lOFl <br />n�„ SIT�Id�[f�ESS: 1921 HOLLOW DALE PL <br />1 FLRG 41b0.G0 <br />( DkIVE ;�5,p� <br />1 S C �4.�0 <br />iL �5,192.10 <br />CNet'�' �5�192.10 <br />LOT 3, SHORT PLAT <br />i <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hours in advance. <br />2. All wor!, c'�all be performed in accordance with the permit and current City of Everett Design and Construction Standards <br />and Specifications. <br />3. Call Location Underground Service 48 hrs before you dig. TOLL FREE NUMBER 811 r- <br />4. Connect rooflop downspouts to the drainage system provided for this lot. <br />5. Install erosion control measures per City of Everett Standards for small parcels <br />6. No dirt, mud, rocks or debris to be tracked onto roadway. <br />7. Contact the Mukilt=o Water District for connecting provisions for this building's water and sewer services. <br />FOR PUBLIC WORKS INSPECTION, CALL CLIFF LINDMAN AT 425339-7404 <br />/1 -G�-G��3 <br />Date <br />PECTION <br />as Constructed <br />WORK AUTtIORIZED DY TIi15 P[R�1R MUST BE STARTED <br />PURSUED TO COPIPLETION. THIS PERNIT P1AY BE CANCI <br />W <br />F <br />� <br />� <br />� <br />h <br />z <br />0 <br />� <br />� <br />0 <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and <br />save harmless the City oi Everett from any and all claims for <br />damages, costs, expenses, or causes ot action that may arise <br />because of installation and maintenance oi the improvement <br />or other right-of•way use hereto applied tor and fuAher agrees <br />to remove same upon notice from the City and to replace <br />public propeAy damage hEFeby. <br />" /�. /• u� <br />of Applicant <br />Date <br />M�S OF DATE PERDIR IS 15SUED AND THEREAF7ER IS TO BE DILIGENTLY <br />CI'TY UPON ANY STOPPAGE OF WORK ON THIS PRO)ECT OVER 90 DAYS DURATION. <br />