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9 1 92 � — � � Z� +� / <br /> Date�L ���_ w,eiu.workapermit 3�2 3� <br /> Applicatlon For T(� p��T!N G Blap.Depl.• <br /> PUBLIC WORKS PERMIT Publ¢WorbFee <br /> Totel Fee s <br /> r � ; .-; , . - , Less Rppt Fee P�iO S <br /> P�Illt Of TypE ��l�y , � . � � eaianceDue S Z� <br /> c < �� � � � � <br /> �. .. � . i � � . . <br /> L' _ <br /> � fl <br /> Colony Graft 14410 Bel-Ited Rd Bellevue�_� 98007 � 644-2323 <br /> Owner Meil�ng Address �� ; -� � �City� �� � � � Zip Phone <br /> ��ii � r'i i.l <br /> � � i li: �: � . <br /> ' Applicant Mailing Address City Zip Phona � <br /> New house Basic 167 � <br /> 'Jescribe Proposed Work <br /> Projecl Address(if known) S � ��C� V N �QT � <br /> � <br /> Attach lour(4) copies of plans for proposed work• Draw Io scale and note the lollowing as applicable: � <br /> • Property Lines � Centerline ot street � <br /> � Outline and dimansions ot all ezisting and � Indicate 1 th <br /> proposetl structures on the lot � Show any proposed grading changes <br /> • Ezis�ing and proposed utilities • Show measurements � <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> t.A�I ca��s lor�nspect�on eha��be mede 24 hra�n advance•phone 259-88/0. � � <br /> 2.All work shall be peAormed in accordance with this permit and current City ot Everett Design and Constructlon <br /> Stendards and Specificationa <br /> 3.Cell Lxation Underground Service 4B hrs.before you dig.TOLL FREE NUMBER 1•800-424-S6SS. � <br /> 4. Install rock construction entrance brhind driveway as per city <br /> standard N208 and erosion control as directed by Public Morks O <br /> Inspector. <br /> 5. Neep city streets clean at all times <br /> 6. Curb qutter and sidewalk in the plat are new and unda�aged, � <br /> any da�age lhereto shall be replaced at the discretion of the <br /> Public Morks Inspector. � <br /> 7. Any change in the driveway cut �ust be approved by the PY In- <br /> spector, width at prop line li�ited to existinq apron width. O <br /> 8. Connect all roaf, yard and driveway drains to stor� drain <br /> systes provided to lut. /� <br /> 9. Adjust water boxes to grade at end of construction. �i <br /> 10. Driveways shall be completely cured before driving on the�. <br /> ^�v ACKNOWLEDGEMENT OF CONDITIONS <br /> /\7 <br /> J The undersigned owner/applicant hereby agrees to hold and save ha�m- <br /> �, A less the Gry of Everell trom any and all claims for dama9es, costs, <br /> {�// � � expenses. or causes of aclion that may arise because of installation <br /> ���L���i' ' / � � yZ and maintenance of the imProvement or other right•of•waY use hereto <br /> � applied for and lurther agrees to remove same upon notice Irom the <br /> Approved for Constw�36n , Date City and to replace public property damaged thereby. <br /> ������.��' 3-3� -rj'� ,.� <br /> FINAL INSPECTION pa�e U� ID I CZ <br /> Approved as Constructed Signature A plicant ale <br /> � PUBLIC WORKS DEPARTMENT WORK AU RIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200CedarStreet 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everet4 WA98201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone:259-8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON'HIS <br /> F'ROJECT OVER 90 DAYS DURATION. <br />