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.� <br />�� � <br />, t�l.t�ld !T <br />PUBLIC WORKS PERMIT <br />City of Everett Public Works Department <br />Date: 12/1/20Q8 <br />Public Works Permit #: PW0812-002 <br />3200 ¢egar Street 1?-Ol �Oi18(M01�) 1b:40 Buildina Permit #; <br />Everett�,yyq, 98201 �G-1 G3�ninp Reference #: <br />(425) 257-8810 CT 1 <br />F'ER��iiT i�o.0illu12 Public Works Fee $: <br />Other $: <br />C0811-012 <br />$ 25.00 <br />OWNER NAME AND ADDRESS: 1 HECH AP ' F NAME AND ADDRESS: <br />L. . <br />SHUBINA LYUBOV G 8 SHUBIN PAV I F'�C �1�0.00 <br />1919 HOLLOW DALE PL 1 F'LHG �1��•�;}�� TA POSTING.. oEc Z 7 2oto <br />EVERETT WA 98204 � GRII�E �LJ.W <br />1 5 C q4.�) <br />PHONE: 4253873873 Il PH��UBilUll <br />TAX PARCEL ID # 00537900001901 nLUb. SIT�- SS: 1923 HOLLOW DALE PL <br />r �i-'+.�,4N <br />DESCRIPTION OF PROPOSED WORK: 1 F/C �1��1.U) <br />NEW HOMF- BASIC 325 1 f'LBG a1tiD.GG <br />1 DRIVE �25.W <br />1 5 C 84.50 <br />TL �5.192.10 <br />CHEL'K 55�19�.10 LOT 2, SHORT PLAT <br />PERMIT CONDITIONS <br />1. AII calis for inspection shall be madE 24 hours in advance. <br />2. All work shall be performed in accordance with the permit and current Ciry of Everett Design and Construction Standards <br />and Specifications. <br />3. Call Location Underground Service 48 hrs before you dig. TOLL FREE NUMBER 811 � <br />4. Connect rooftop downspouts to the drainage system provided for this lot. <br />5. Install erosion control measures per City oi Everett Standards for small parcels <br />6. No dirt, mud, rocks or debris to be tracked onto roadway. <br />7. Contact the Mukilteo Water District for connecting provisions for this building's water and sewer services. <br />FOR PUBLIC WORKS INSPECTION, CALL CLIFF LINDMAN AT 425-339-7404 <br />�--7k�.;. _/.�t-�� /�-oi-��a <br />App oved for Construction Date <br />�ECTION Date <br />as Constructed �'�� <br />\VORK AUTIIORIZED E3Y THIS PERh11T 1•1UST BE STARTED <br />PURSUED TO COP1PLtTI0l1 THIS P[RI•1IT P1AY BE G1NQI <br />� <br />F <br />� <br />� <br />%Q <br />O <br />ti <br />z <br />0 <br />� <br />� <br />0 <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applican� hereby agrees to hold and <br />save harmless the City of Everet� from any and all claims for <br />damages, cosls, expenses, or causes of action that may arise <br />because of installalion and maintenance ot the improvement <br />or other righl•o(-way use hereto applied for and fuAher agrees <br />lo remove same upon notice from Ihe City and lo replace <br />public prope� damaged thereby� <br />Signature of <br />Date <br />(N 180 DAYS OF DATE PERh11T IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY <br />�l' TIi[ CITI' UPON P.'�'Y STOPPAGE OF WORK ON THIS PRO]ECi OVER 90 DAYS DURAl10N. <br />