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��� <br /> O � S <br /> C M <br /> � H5ti <br /> Hz� <br /> 'i1H � Date �-R-Q� ... � .1Q lOJI��V ZL Z-. v„oi��wo,c.a�,mn. ���-�� G 1 �'_/ <br /> BIOO.DePL• <br /> O Z � APPlication Foi . , . <br /> y �J PUBLIC WORKS PERMIT vubTotnlFeeFee s <br /> HL��)O . �e.,.Poi Fea a.�a S_ <br /> L7• C7 r�� ' ' ., Enian^eDue S <br /> C r � �' <br /> a y 3 Prini or Type Only " : ` <br /> � i �1, i r i �n i�. <br /> r��yy' H � '' ; <br /> Oy tr Hanabrook Inc � �E 4020 Main Spokane dA�� 99202 (509) 534-0644 <br /> O C7 y r. Malqng�Address �� C � . �p Phone <br /> q Owner '< < � r�, ::_ . Zi <br /> �[s7C'� r r� _� `'r .� .� � � i�- i�i <br /> �t� �� �i i�I (, � r i i �� <br /> �w �i ' tr : <br /> Owner pi��„c <br /> y y Applicant Mailing Address ��ty Zip ` ` <br /> T' <br /> Describe Proposed Work <br /> new SFR �"� 3� � <br /> W <br /> P�ojed Atldress(il known) <br /> �� �i���� �v� � <br /> � <br /> Atlach lour(4)copies ot plans�or proposed work• �raw to scale a���note lhe tollowing as apPlicable: � <br /> • Properry lines • Centerline of slreel <br /> • putline and dimensions of all existing and • Indicate North <br /> proposed simctures on the lot • Show any proposed giading changes <br /> • EKisting and proposetl utili�ies • Show measurements M <br /> !�1 W <br /> � DO NOT WRlic BELOW THIS LINE /,� <br /> '�' PERMIT CONDITIONS � <br /> '�� 1.All calls fo�Inspection shall be made 24 hr..in adva ice-phone 259•8810. � <br /> 2.All work shall be pedormed in accordance with this permit and current City ot Everett D=Sign and ConsY�ction <br /> ' ' Standards end Specifications. � <br /> � 3.Call Location Underground Service 4B hrs.betore you dig.TOLL FREE NUMBF.R 1•800•424•5555. <br /> '�1 4. Instal.l ror,lc r.�pstCUCtif�Il entranre behind drivewat� a� P�I' � � , � O <br /> etandard tt?.08 and ero.�ion rontrol as di.rerted hy Puhlic Works, <br /> 1 ' Tneper,tor. <br /> � 5. Keep r_itY atreete clean at all timee � <br /> '-' 6. Curh ��tY.er and si_dewal.k in the plat are new end und.smaeed. <br /> any damage thereto �sh� '. 7 be repl.aced at the discretion o£ t.he 'w <br /> ' Public Worke 1nsPPr.tnr. VJ <br /> � 7. Any r_hanee in fihe dri��ewaY cut musT, be approved bv Che Fublic � <br /> � Work� Tnapector. <br /> � 8. Ti�htl !ne all roof, card �nd driv�way dr�inR Y,o etorm dr�in � <br /> ' 9f,Ut)fl At. �'.1PC:� fa�(jP C�': E1tfjP.W<ii)C. <br /> 9. Ad.ivat. waYer boxeF to �rade at end of coneS;ruction. <br /> �' 70. Dri-veway� �h�ll be compl.etelY cut'r,d bef��re drivina_ on th�m. <br /> � <br /> ACKNOWLEOGEMENT OF CONUITION <br /> � � <br /> �� The undersigned owner/anPlicant herebY agrees Iu hold and save iarm� <br /> - � — less ihe City ol Everetl irom any and all claims lor damages, costs, <br /> expen5es, or CauSes ot aCtion ihat may ari5e be[3use ol installation <br /> � � I _ S ( _c1 C and main'enance o1 the improvemen� or oiher riqli4ol-wa•/ use hereio <br /> � !�'�� (("�� � app�ied lor and luriher agrees to remove same upon no!ice from ihc <br /> �U -"— <br /> Approved for Construytion Dale C�ty and to reGlace public property damaged thereby. <br /> ,t��-:--G� G-r 9 �_ �. 7 <br /> / � '`L` I_J-4c�� — _ <br /> FiNAL INSP[CTIGN Date � � Date <br /> Approved as Consirucled Signa�ure of ApPlicant <br /> � WORK AUTIIORIZED BY THIS PE'iM1T �AUST B[ STARTED WITHIN <br /> 'r1� PUBLICWORKSDEPARTIdENT 180 DAYS OF DATE PERMIT IS 13SUED AND THEREAFTFR IS 70 <br /> 3200 CeOar Sireet BE DILIGENTIY PURSUED TO COA:PLETION.P�d5 PERAIIT MAY �E <br /> Everett,WP 98201 CANC[LLED BY THE CITY UPON ANY S7GPP:'dE OF V/ORK ON THIS <br /> Phone:259-B810 PROJECT OVER 90 DAYS DUtiATION. <br />