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/� / <br /> I� � �^ W • publit Works Pem.11• <br /> 4-19-93 eiao.oeo�.• <br /> oece.--- TO P(1CTING_�o ��� ��— <br /> Application For pu�l¢Works Fee s—_ <br /> WORKS PERMIT To�elFee <br /> p�,J g l.l C �e�a eoo Fee aa�e :_— <br /> B�lance Due s ���� <br /> Print or TyPe Onry : � <br /> Crai.c 14410 Bel Rfld Rd Suite 200 Bellevue WA 98007 ZIP phone <br /> Colony Mai4ing Address � Ciry . <br /> 0�_ <br /> . ' . . . . . . � � � Phone <br /> pwnet City Z�P � <br /> Mailing Address <br /> APPllcant � <br /> new house <br /> Descrlbe Proposed Work —�- <br /> - W <br /> Lot 9 Hanabrook � <br /> 5632 Perkview Lane � <br /> Praiect Address Iit known) — � <br /> • Centedine ol slreel <br /> Attach tour(4)copies of Plens for proposed work- Draw to scale an�note tha following as applica e: <br /> � praperty Lines • Indicate North <br /> • Show enY Proposed greding changes � <br /> • Oulline and dime �,sions ot all ezisling and � Show measurements <br /> pro�osed structures on the lot <br /> • Exisling and proposed utilities O <br /> DO NOT WRITE BELOW THIS LINE 1 <br /> PERMIT CONDITIONS � <br /> 1.All calls tor inapectbn shell be made 24 hrs.�n advence•phone 259-8810• � <br /> p,p��y,rprk shall be pertorrned in accordence with this permlt end current Clty of Everett Desi9�24•5555.cllon <br /> St:�dards and Spec�flcetions. <br /> 3.Call Lacetlon Underground Service 48 hra be�°�e you dig.TOLL FREE NUM��r city O <br /> 4� e���p208cendte�sion cont oleas directed bYa�blic Worka <br /> I�pector. � <br /> 5, �p city streeta clean ut all timea � <br /> g_ �.b gutter and sides�elk in the plat are neW �d '����' <br /> any aemage thereto ehall h° replaced at the discretion of the O <br /> pablic Works IneP�tor. roved bY t� � In- <br /> � �ny ohet�ge in the drivai�aY cut muet b� app a �n Width. <br /> epector, Width at proP li� l�ited �ai�gto stomm ci�'ain a <br /> g. �onnect all roof, Y8� �d �'ive�+aY <br /> syetem pravided to lot. <br /> 9. Ad,i�t water boxee to BL'�e at end of constdrivinB on them. <br /> lO. D['1VeH9Y8 e�ll � °O�letely �li� �f�� A�KNOWIEDGEMENT OF CONDITIONS <br /> � The undersigned owner/apPlicant hereby agrees lo hold and save harm• <br /> qJ less the Gily ol Everell lrom anY and all claims for damages, costs, <br /> uSe hereto <br /> expenses, or causes ot action that may arise because ol inslal a ion <br /> 3� and maintenance of lhe improvement or olher righhoi•weY <br /> G apPlied lor andaCetPubl c9p�operoYrdamagad therebyn ��otice trom lhe <br /> Date Ciry and to rep <br /> pp roved for Const tio� '/ J.�" <br /> /U/S-f� QjfZ/ �� <br /> �t D te <br /> Dale ure of APPlicant <br /> FINAI INSPECTION y,/ORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHI <br /> qpproved as Constructnd <br /> PUBLICWORKSDEPARTMENT 180 DAYS OF DATF. PERMIT IS ISSI�ED AND THEREAFTER IS T <br /> BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> � 32p0 Cedar Streel CANCELLED BY THE CITY UPON ANY STOPPAGE OF WOFK ON THIS <br /> Eve�ett.WA 98201 PROJECT OVER 90 DAYS DURATION. <br /> Phone:259-BB10 <br />