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t <br /> � �y� <br /> D �lx <br /> C, H <br /> 9 �Cn <br /> i <br /> Ox0 � �� <br /> � H � TO Pu���[1Vo�kp Pe�mil� _ .�� <br /> yy ~ ' _�� � -- <br /> Dale 7-17-49 � P(�STI�G �-_ ,_i <br /> x y3 eiao DepL• 37416 <br /> O H� APPlicalion Fo� _ <br /> WORKS PERMIT PubLc\4orklFlB S <br /> PU B L I C Tole�Feo <br /> HC�+l � �essanoi F�ePn�o 5 �J <br /> G']� C] eni��«o�0 5�� <br /> ay Print or Type Only <br /> xN <br /> r�1�"� y Select Homes Inc 237 Elm St Everett ldA 98203 258-1508 <br /> C7� N yy�,�[-0{}p�+�6YXXXXXIFXXXs�I�#�Q�h'y+���XXXXXX}6U707IC&Yt�('7tkS(�YX�XXXX}G6R�XMT37G.`FX�i6WY+ <br /> O tl V� CiIY ZiP Phonc <br /> �� �+ Owncr Mailing Address <br /> p y XItK![3C}H4XH�CX}�7CT�L3E'(]Gb�X.'�SR1fl7NGK}@R`(.t:'{i�XSG{SE3iL`6QrlX , <br /> - � — Mailing Address City Zip Phone <br /> APPlicant �. f ,` <br /> v- <br /> Describe Proposed Work <br /> new house construction <br /> W <br /> Project Address lil knownl Lot 13 �l�� ���K v� � y'v� � <br /> � <br /> Altach lour(4)cop�es ot plans tor proposed work• D�aw to scale and no,e the following as applicahle�. � <br /> • property Lines • Centerline ol street <br /> • Indicale Norih <br /> • OuUine and dimensions of all e:isting and � Show any proposetl grading changes � <br /> proposed structures on Ihe lol � Show meesurements � <br /> • Existing and proposed ulilities <br /> I I DO NOT WRITE BELOW THIS LINE ^ <br /> 1�' PERMIT CONDITInNS � <br /> '�' 1.All calls for ins�^clion shall be made 24 hrs.in advance-phone 259•881 O. � <br /> 2,All wod�,shall ho'vedormed in accordance with this permit and current City ol Everetl Design and Consiruclion <br /> � Standards and 8oecificalions. � <br /> �„� 3.Call Location Under9round Service 48 hrs.before you dig.TOLL FREE NUMBER 1•B00•424•5555. � <br /> �}, Install rock construction entrance hehind drrv�waF`1�li.�et4oi4:s/ <br /> '�1 standard �2i�8 a�d erosien rnntrol as directed b;� � <br /> ' Inspector. <br /> ,� `�, Keep city streets clean at all times <br /> b. Curb qutter and sidewalF'. in the plat are new and i�ndamaq�d. � <br /> � any damage theretu shall be replaced �t the discreh.ion o4 the <br /> '� Fublic WorV:s Inspector. roved by the F'W In- � <br /> ��' �� � 7. Rn� change in the drivewaY cut must be app � <br /> '. spector, width at prop line limited to e;:ist.ing apron widt.li. <br /> '� 8. Connect all roof, /ard and drivewa/ drains to storm drai.n <br /> ! s/stem provided to lot. a <br /> ��I 9. Ad.iust water bo::es to qrade at end of construction• i_h�am. <br /> 10. Driveways shall be completely cured before driv.inq on <br /> '�' AC4:iJOWLEDGEMENT OF CONOITIONS <br /> a <br /> i�1 The undersi9netl .vneqapplica�l hereby agrees to holtl and save arm� <br /> ��- J less Ihe City ol �aerell Irom any and all claims lor tlama9es, cosis. <br /> � /��C� expenses. o< <auses ol act�on ihat may arise Gecause of inslallation <br /> / � // ����� and maintenance ol lhe improvement or other right�ol-way use herelo <br /> ,�/t/ � applietl br and lurther agrees lo remove same upon nolice irom Ihe <br /> qp�p�ed�pr Construction Date Cily and lo roplace pu6lic property damaged Ihe�eby <br /> f1�' � �' .. <br /> n/ 3--�r- i3 r . �cU �C � Ll��:�-�_ � �.':' ;r �s/� ���..�_. <br /> ,ro � <br /> FINAL INSPECTION Date � Dale <br /> Signature ol Applicaot <br /> Approvetl as Constructed NrpRK AUTHORIZED BV THIS PERMIT MUST BE STARTED WITHIN <br /> PUBLICWORKSDEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> D��� 3200CedarStreet BE DIUGENTLV PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Everelt.WA98201 CANCELLED BY THE CITY UPON ANV STOPPAGE OF WORK ON THIS <br /> phone-.259�8810 PROJECT OVER 90 DAYS DURATION. <br />