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;R TO POSTING <br />SIpplicalion For <br />PUBLIC WORKS PERMIT Date 12-21-9s <br />W <br />c <br />PUBLIRKS DEPARTMENT Public Works Permit If -- <br />J JCedar <br />Street <br />Everett, 1117A 98201 259-8810 Building Permit # 50364 <br />lz f9l 8 Eton00 �SBBEB <br />�.y� <br />TYPE OR PRINT ONLY "- o w o 'Ai ca o + o 'Co o_i Public Works Fr $ <br />y Cd L? N W CC C.-- n Ca b1 PI 4 <br />Loren Dorrah 2820 Lincolt*Ay LynnwQd"98037 787-6700 <br />Owner Mailing Add s� n to ^- �(o'� City [[C[te�n Zip Phone <br />coOL9 (L?�=.CL <br />Curt Johnson 337-473 W C, ! W rn a CJ a. s ui s <br />Applicant Mailing Addr s City Zip Phone <br />Describe Proposed Work new duplex <br />Uj <br />��tttttt/tt�� <br />— <br />V♦ <br />PROJECT ADDRESS (if known) 2020 Hollow Dale P1 Lot 7 SP #24-94 <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 <br />O <br />O'Centerline of street •Indicate North *Show any proposed grading changes •Show measurements <br />PERMIT CONDITIONS: <br />1. All calls for inspection 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 />!. Driveway lvidening shall he in contbnmuice wilt city of Everett standard phut 1i307. <br />Roottop runoff ntay be discharged onto splash blocks or into downspout infiltration <br />systeuls and driveway inwoff Should be. encouraged to infiltrate into glassy or haidscai;ed <br />W <br />+7%l� /Z��8/ ys� <br />Approved for Construction Date <br />Fff JAL rINSPECTION Date <br />Approved as Constructed <br />z <br />O <br />V♦ <br />O <br />a <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 />damage thereby. <br />f�c1 wi1.Y1 <br />Signature of Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT 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 />