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1 <br /> ��a � <br /> 07dx <br /> G H <br /> � Htn <br /> y � H <br /> � N � T l'G�T � / ��Z 3� �� <br /> Date �'1�-9Z O �NG � a�oncworxePermit• �� <br /> z �`Z— ome�0em.. 37421 <br /> Applic:ltion For �y� <br /> � � � PUBLIC WORKS PERMIT P°°�°�YO1kSFe0 <br /> � � g ,�„�F�e S <br /> (f]y ("� Less Appl Fee PaiC $�� <br /> a y� Print or Type Only o��,�=a o�� S !-�� <br /> r <br /> t7 v�i H SELECT HOPfES 237 ELPi ST EVfiRETT WA 98203 258-1503 <br /> n C y �X�18�&xx�`t7F�JR1�tXXXXX%7:xY,708I1XXx45x�iXffiXrlXXXX%xXX16�5M7c�X�54XXB8&�87tXxXXXbH&AX�BX,}FH8l4X <br /> � ��� � Owner M2iling Address City 2ip Phone <br /> y p y .ar.k erace (509) 534-0644 or Tom Bowen 353-4807 <br /> AOPlir,ant Mailing Address City Zip Phone � <br /> � <br /> Describe Proposed Work new house construction ' <br /> ProjectAdtliesslilknownl Lot 21 �'...�""Ig �Ar�ev�E�y Ln.�, �L <br /> r <br /> Attach lour 14)copies ol plans lor proposed��ork� Draw to scale anC note ihe lollowing as apWicable: � <br /> • Property Lines • Centerline ol sireet /w <br /> • OuUine and dimensions of all existin9 and � Indicate North V, � <br /> proposed strucWres on Ihe lot • Show any proposed c�radin9 changes <br /> '�' • Exis�ing and Froposetl u�ili�ies t Show mezsuremenis � <br /> ' ' DO NOT WRITE BELOW THIS LINE <br /> PERMITCONDITIONS O <br /> � 1.All calls lor inspection shall be made 24 hrs.in advance-phone 259•8810. <br /> 1 ' 2.All work shall be pertormed in accordance svith this permil and current City of Everett Design and Conslmction � <br /> Standards and Specifications. <br /> 1� 3.Call location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1-800•424•5555. � <br /> 4. Install rocf�. constructian entrar,ce behznd driveway as per city <br /> f�o st�ndard �t268 and erosion r.untrol as d.i.rect.ed ��ry Public Wor4-.s <br /> 1 ' Inspector. � <br /> ,� .. . I{eep cit� streets clean at all timee: <br /> 6. Curb qutter and sidewalk in the plat ar-e new and undamaged, <br /> ' ' an/ damaqe i:hereto shall be replaced �t the discretion of the � <br /> �r Fublic Works Inspector. 'w <br /> � 7. Any �hanGe in the driveway cut must be approved by the F'lJ In- V, <br /> spector, width ai prop line IimiCed to e:;istinq apron a�i.dth. <br /> �y� C�. Conner_t all roof, y2rd and driveway drains to storm drain O <br /> '� sistem provided 1:0 lot. � <br /> � 9. AdjusL water bo;;es to grade at end of cnnstruction. <br /> 1 10. Drivew�ys snall b� completely o_ired 6e�(orEr drivinq on Chem. <br /> I ��.o ACKNOWLEDGEMENTOFCONDITIONS <br /> The undersigneA owner/applican�hereby agrees to holtl and save harm� <br /> —i� � less the City ol Eve�etl Irom any and all claims lor tlama9es, costs. <br /> , / /�� /A/ e:penses, or causes ol action Ihat may arise because ol installation <br /> //�G /f�/ /��LQ— �7 lZ antl maintenance ot the Improvement or other righl�ol-way use hereto � <br /> f� � applied�lor and luriher agrees to �emove same upon nolice Irom the <br /> Approved for Co�n Date City a tlj�rePlace blic Pronerty damaged thereby. <br /> � � � �_ �.f-f) ��l.L��'�� �/ �ZLJ 'S�I,��� <br /> FINAL INSPECTION Datc � v� � � � <br /> ApprovedasConstructed S naWre AFDlic�nt Date <br /> W RK AUTHOPI2ED BY THIS PERMIT MUST BE STARTED WITHIN <br /> �4���� PUBLICWORKSDEPARTMENT 180 DAYS OF OATE PERMIT IS ISSUED AND CHEREAFTER IS TO <br /> 3200 Cedar Street BE DILIGENTLY PURSUED TO COMPLETION.7HIS PERMIT �JAY BE <br /> Everetl,WA9B201 CANCELLED BYTHE GTY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259�8810 PROJECT OVER 90 DAVS DURATION. <br />