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N _ � _ � _ y- , <br /> Date 9�1/92 / <br /> PUEIic WorFs Permll• � <br /> Applicntion For eieQ oeo�.• 37880 <br /> PUBLIC WORKS PERMIT PUOToteFeeFee s <br /> ' Less Appl Fee PeiO S <br /> Print or Type Only Tn �nSTI NG s'1-�'q� e.�.��ao�e s Z� _ <br /> � Colonv Graft 1u410 AP�—TP(I ua RP��PVf�G �g007��4-�373 <br /> pwner Mailing Address City Zip Phone <br /> A <br /> �` Applicant Mailing Address Ciry Zip Phone ( �y� <br /> � V � <br /> Describe Proposea WorM New Houae Basic 168 O <br /> Prolect Address(if known) ��O r A��'���� �U� �`-� � <br /> � <br /> Attach four(4)copies of plans fo� proposed work- Draw to scale and note the following as applicable: � <br /> • Property Lines • Centerline of street � � <br /> • Outline and dimensions ot a�l existing and • Indicate North <br /> propesed structures on the�ot • Show any proposed grading changes <br /> • Existinq and proposed utllities • Sh.;w me2surements � <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1.All calls tor Inapectlon ahall be mede 24 hrs.in edvance•phone 259�8810. � <br /> 2.All work shell be peAormed in eccordance wlth this permit and current City of Everett Oesign and ConstrucHon <br /> StandarcJs and Speciticetiona <br /> 3.Cell Location Underground Service 48 hra before you dlg.TOLL FREE NUMBER 1•800�424•5b55. � <br /> 4. Install rock construction entrance behind driveway as per city <br /> standard N208 and erosion cantrol as directed by Public Works O <br /> Inspector. <br /> S. Keep city streets clean at all ti�es <br /> 6. Curb gutter and sidewalk irt the plat are new and unda�aged, � <br /> any da�aqe :hereto shall be rcplaced at the discretion af the <br /> Public Morks Inspector. � <br /> � 7. Any change in the driveway cut •ust be approved by the PM In- <br /> I spector, width at prop line li�ited to existinq apran width. O <br /> , 8. Connect all roof, yard and driveway drains to stor■ drain <br /> syste■ provided to lot. � <br /> 9. Adjust water boxes to qrade at end of construction. <br /> 10. Driveways sfiall be caspletely cured before drivinq on t`hes. <br /> �� ACKNOWLEDGEMENT OF CONDITIONS <br /> �-- <br /> The undersigned owner/applicant hereby agrees to hold and save harm- <br /> less ihe City of Everett irom any and all claims for damages, costs, <br /> �—��� ezpenses, or causes of action that may arise because of ins��ilstion <br /> and maintenance of the improvement or other righ!•of•way use hereto <br /> applied f�r and further agrees to remove same upon notice from the <br /> FApproved for Construction Date Ciry and to replace public properry damaged thereby. <br /> i{����/'� 3:!1-s'3 � `\�1 . /� <br /> FINAL INSPECTION Date ��-C-� `�-� Q � �-'�-1� IIi�I�/�� <br /> Approved as Constructed Siqnafure \f pplicant— Date <br /> � PUBLIC WORKS DEPARTMENT N'ORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> t80 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200 Cedar Street BE DILIGENTLY PURSUED TO COUPLETION. THIS PERMIT MAY BE <br /> Everet4 WA 98201 CANCELIED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259•8810 PROJECT OVER 9� DAYS DURATION. <br />