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% <br /> $ � � <br /> [S] <br /> D x <br /> C H <br /> 9HfA <br /> Yxy <br /> Hz � <br /> 1� c] <br /> H:u <br /> �y� Date ,_R_�� TO POSTING � Z Z� ��o,�wo,,.P�,m,,. �z c � �� <br /> y eiao oeo�.• 92/35283 <br /> qpplication For <br /> � �d PUBLIC WORKS PERMIT PuOI¢Wo�xsfee <br /> o r-� ,o�.�F�e a <br /> H� g ' LauRo�l iee Paia $ <br /> 'n� n � �-, BeienceDue S <br /> �"� c Print or Ty�e Only � � � <br /> � y .j�, �-; i; �: � � <br /> gNti � •, ; <br /> H 1lanabrook Inc E. 4020�-Main S�pokaqe WA 99202 (509) 534-0644 <br /> n�y Owner Mailing,AddrOas � � 4ty Zip Phone <br /> � � <br /> r; � : i <br /> _ � �. <br /> ��� Owfle[ �l i . , � ii . i •: , . .. <br /> Appliwnt Mailing Addiess City Zip Phone , ,` <br /> ll'! <br /> �escribe Proposvd Wo�k new SFR �� 37 _ ~ <br /> ,, ,. 1 W <br /> Proiect Atldress�il known� �O�Z4 � �� ��� �-�( F'yv A�C -- � <br /> Attach lour(a)copies ol plans for proposed work� Draw to:cale and note the following as a,plicable: � <br /> • Property Lines • Cenlerline of street (^ <br /> • Ou�line and dimensions of all eMisting and • In�icate Norit V� <br /> proposed structures on Ihe lot � Show any proposatl grading changes � <br /> • Ezisting and preposed u�ilities • Show measuremenls �/� <br /> f ' DO:�OT l:'RIIE BFLOW THIS LINE � <br /> '�I PcRM1T CONDITIONS O <br /> 1.All calls�or inspection shall be made 24 hrs.in advance-phone 259•8810. � <br /> '!' 2.All work shall be perlormed in accordance with this parmit and current City of Everett Design and Consiruction <br /> Standards and Specilications. <br /> � ' 3.Call Location Undergro.mA Service 4B h•s.belore you dig.TOLI FREE NUMBER 1•800•424•5555. � <br /> 4. Tnst�: l ror_k .r.�ngtrurt,ion entrarr_e hPhind drivewav as per rity O <br /> ' �tandard fi7.0A ;,>>d ero�ion control r,s direr_te�l hy Public Worke <br /> ' Inspe�tor. <br /> 5 . KeeP c�tv �treets r.]e3n at all times � <br /> '�1 6. Curb gutter and aidewalk i.n the plat are ne�� and undamaged, <br /> an�� damaee thereto r�hal] be replar_ed at the discretion of the ,w <br /> ' f Fub} in WorkA IntaDer.t,m�. V✓ <br /> � 7 i1nY change in the driveway cut muet he aqprnved b�� the Puhlic O <br /> �C W:�rks 7neper.tor. <br /> �1 F? . Tightl.ine al.l ro�f, Yard and drivewaY drainr� to atorm drain ^ <br /> ` ^tub:� aY, Uack side �f aidewalk. ii� <br /> � 9. ?d,iu�t water hnxea tn �r�de �t end of conetruct;ion. <br /> ' 7�. Drivewav^ �hall h� comPl�t�lv cimPd beforc drivin� on thrm. <br /> ' n/I„ ACKNOWLEDGEMENTOFCONDITIONS <br /> �� <br /> � _ The undersigned owner/applir.ant hereby agrees to hold and save harm� <br /> - -- less ihe Cily ol Everett Irom any and all claims lor damages. costs, <br /> ; �� eApenses, or causes ol action thal may arise because ol installation <br /> I I C-/I I �� i � � � and maintenance o� ihe improvement or other right-of-way use hereto <br /> � �l,lv� `�� I \�'�-� ` ` � � appM1ed for and further a9rees to remove same upon notice Irom thr � <br /> Approved for Constf �lion �a�e City and to replace public property damaged thereby. <br /> / ( / � <br /> �1., �����'- �-r- SL <br /> RNl:LINSP[C710N �a1e ��-�1�. /�TL�T�"� - <br /> Approved as Consiructetl Sign2lure ol Ppplicanl Date <br /> � PUBLICWORHSDEPARTMENT WORK AUTHORIZEO BY THIS P[RMIT MUST BE STARTED WIIHIN <br /> 3200Ce�arStreet 180 DAYS OF Di.TE PERMIT IS ISSUED AND THEREAFTEF IS TO <br /> EveretL WA 90201 6E �ILIGGNTLV PURSUED TO COIdPLETION. THIS PERMIT MAV BE <br /> Phone:25�`-eB'0 CANCELLED�Y 7H[CITV UPON ANY STOPPAGE Of W'ORK ON THIS <br /> PROJ[Cl OVER 90 DAYS DURATION. <br />