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��.r <br /> . <br /> ,..,.�� � <br /> � � c <br /> - ! <br /> f <br /> , <br /> ���p . . ���� <br /> � � , .. .�.a . _,�: �: <br /> �� : . �: <br /> ., �:_,r�z��.� .. �t.� �r -,. _ . :..-�. _ .� <br /> r+ ,..,,, � <br /> �ui� p. /•�(n % <br /> �! - J � 1 — Z`J' { C�obcWorl�Permn• ��/Tv <br /> w �; Date_2�6,C92 92/35571 � <br /> B�op Dept � <br /> � qpplicatlon For <br /> �d F PUBLIC WORKS PERMIT P°°"""°`"`°` -- <br /> M � ,a�.�F�. s � <br /> �p�QJ , t0 POSTIN6_�° aa 9a LenAppifeePeiEs �O <br /> � Q• (7 �� ��' -� . � n r �. � � . r � r !/mceOne-.� C S <br /> � � r Print or Type Only •j , �, : - <br /> y i .-, < <.; ��, � ��' � �� , e � , <br /> ' r- r �� <br /> �� � � � � �i n i � a� u <br /> � � � � :n <br /> p 1-1 4 f' h ok S F amn u i nG� `�`�S�kaneC. • noon2r � ' S34-0 Phone <br /> �� ; Owner .� �'' Maihnc��+tltlrG}so �_:� ` . �.._ DAY . . - 2i6� � �i . , � <br /> � . o '� i i o i , i s r� • ri c i.' ._ �i <br /> � � : �� . , _. _ � . . �� _ � .. <br /> rt �, 1.. ui � � r� ! � r- � 'i iLi �� � . r. � �- i �- <br /> ! � I <br /> ' � . <br /> .3 � Owner — W <br /> A ADPlicant Mailing Address Cdy Zip Phone <br /> J � O <br /> �escribe Proposed Work �nstruct new Sinqle Family Residence <br /> '_ — ' <br /> i <br /> W <br /> ProjeCtAtldresslifknown) 6019 h,o ;A'' A�P (LOT 30) __. <br /> H ' <br /> Attach four(4)copies of plans lor proposed work-Draw to scale and r.Me the inllowing as applicable: � � <br /> � � <br /> • Property Lines i Lr,ct^dine o�sireet . <br /> � Oulline and d�mensions ol all ezisting and 11 Indicale Norib , <br /> proposed stn�clures on the lot • Show any proposed grading changes .� <br /> � • Existing and proposed utilities • Show measurements M � <br /> � ���,I ; DO NOT WRITE BELOW THIS LINE O I <br /> � ' PERMITCONDITIONS � <br /> � ' 1.All calls tor inspection shell be made 24 hrs.in advance-phone Z59-8g10. � � <br /> � ��� - 2.All work ahall be pedormed in accordence with this permil and current City of Everetl Design and Construction � <br /> . StenOards and Specihcations. � <br /> i3.Call Locetion Underground Service 48 hrs.belore you dig.TOLL FREE NUMBER 1•800�424•5555. <br /> I 4 . ineta7.1 r�r,k r.nnst.runtion entr�nre behind drivewap ae per citv O i <br /> : atan�3�r�3 ri7.�f� and ernsinn rnnt.r�l �s �irartPr� l�v Pi�b7ir_ W�rks i <br /> � �� 1nr�pPrt�r. ' <br /> � �. 5. KnPp rj.ty fit.reets clean at all tim�s � � <br /> i 6. �'��rh e»t.t�r anr� eidewalk in the Flat are new and undamneed, <br /> �� � anv damap.e t.hPrPtn ^hall b� r�Flar..ed at t;he discret.inn of the 'w <br /> I `` � � Pnhlic Wnrkt� Tn�neci.nr. V, � <br /> 7. Anv chan�e in 1:hP �Irivewav cut muat he aPProved bv the Puhlir � <br /> Wnrkg TnaFPct�r. <br /> iR. Ti �htline all roof. parA �nd �lrivew�v �raina to eT,nrm drain /� � <br /> �! �tiabR at, ba�k eide of sidPwalk. Ii <br /> 9. Ad.iu�+t water bnxeca tn grade �t and nf conrt.rucfii�n. <br /> i0. Arivew,aye sh�ll hP r.omplatelv cimed baforP drivinc �n them. i <br /> �� ACKNOWLEDGEMENT OF CONDITIONS � <br /> , `�� The undersigned owner/applicaM hereby agrees to hold and save harm- <br /> less the City ol Everett Irom any and all Uaims br damages. costs, <br /> expenses, or causes ol action Ihal may anse Uecause ol installation . , <br /> ��I, A ��0�— �`� ` 1 V_c}� and maintenance ol the improvement or other riqhi-obway use herelo <br /> �/� applied lor and lurther agrees to remove same upon nolice Irom the <br /> Appro�ed for ConsVdction Oate City anA to replace public property damaged thereby. <br /> J� C/�-� G• � �2 <br /> J\`��.�f--� I <br /> FINAL INSFECTION �a�e Date <br /> Signature ol ApPlicant � <br /> Approved as Conslructed �� <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN . <br /> �� PUBLIC WORKSDEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO I <br /> ,V� 3200 Gedar Street BE DILIGENTLY PURSUED TO COMPLETION.TNIS PERMIT MAY BE <br /> EvereH,WA 98201 CANCELIED BY THE CITY UPON PNY STOPPPf E OF WORK ON THIS <br /> Phone:259�8810 PROJECT OVER 90 DAYS DURATIQN. , <br /> il <br />