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• <br />w <br />� <br />� �Plication For H <br />PUBLIC WORKS P�iMIT <br />� <br />PUBLIC WORKS DtPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 259-8810 <br />;;;, POSTING Nov 2 � . - <br />TYPE OR PRINT ONLY o 0 0 0 0 <br />oinoioo <br />aoo�o <br />PAUL BUSTARD CONSTRUCTION PO BOX 1202� Et'ERp,� <br />p�-��P- PAailing Address City <br />0 <br />v� <br />o te �'8/19/97 <br />a _ m . <br />�i <br />Public Works pqrmit N G� �� <br />W <br />Buiiding Pe� 56274 <br />��,_ <br />E <br />Describe Proposed Work NEW HOUSE — BASIC 1200 <br />PROJECT ADDRESS (f known) <br />Attach four (4) coples of plans for proposed work - Draw to scale and note the following if applirable: <br />•Property Lines •Outline and dimensions oi all existing and proposed structures on the lot •Existing and proposed utilities <br />'Cen�erline of stieet •Indicate North •Show any propcsed grading changes •Show measureme�ris <br />PERMIT CONDITIONS: <br />1. All calls for inspection shall be made "e4 hours in advance - phone 259-8610. <br />2. All work shail be performed in accordance with this permit and current City of Evereti Design and <br />Construction Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. <br />I lnsicill an iotilh•�lion h'encli bnilt ati pur Seclion 3-2.G.2 a.u( T'ieure nnd T�Lie 3-2.2 of�he citt� <br />atornnr•.iler �ta�i�eemei�t htviu�l (copy's staplad [o this ueiYnii}. "llie iuCil�,aticn t;•ench �I�all be n� <br />�{o,ar th:ui 5 fzet to �u�}� up slope prope��tp line or i'ouudolicn nor closor Ihv� lO leet to �u�y do�v��slo� <br />, roperty line or foundation. C�11 Public �Vmi:s for :u� �uspection prior to coveriqg irenches. <br />t3xvnple: 'Il�ie shvcture ha�s �y�n��o.. 23e� s�. i't. ofimpre�vious roofsveFi. 'lliereiore. <br />iCa :oil cla�ss oClna��e �� scuir! is asssumad :uid Ihe infilfratimi iranch is couslucled <br />t%r. dd¢A �//t[l: Ti_�'.'I�JC, fi�om t�t,lc 3-2.2 Qic 6•cnch should be 2 � , t. Lun . <br />H�cnnditiom iu (na lizld vtuy fi�om tl�ose in Ihe ex:unple -lcljust accordiqgly <br />u�ine. tliu ab�va mcnlionzd l�il�le as a guide.. <br />Z <br />Date <br />Approv� Jonstructed <br />7 <br />�f � <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned cwner/applicant hereby agrees to hold and save hartnless <br />the City of Everett trom any and all clalms for damages, costs, expenses, or <br />causes of aclion that may anse because of installation and maintenance of <br />the improvement or other right-ot-way use hereto applied lor and fuAhei agrees <br />to remove same upon notice irom the City and to replace public pr�peAy <br />damaged thereby. � <br />�- �'/z ��47 <br />Signa ure o t ate <br />WORK AUTHORIZED BY THIS PEI;MIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS TO BE DILIGENTLY PURSUED TO <br />COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF V/ORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />