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Applica�ion For <br />� PUBLIC WORKS PERMIT <br />PUBLIC WOR �KS� DEPAFTMENT <br />3200 Cedar 5!reet <br />- p�STING ,��� i � �WA9�, z59-ae,o <br />1Vv� �,� <br />o n <br />r: r_� r.r� <br />TYPE OR PRINT ONLY '��-, ci o <br />3' � � <br />Werner Ohmes 4938 Narbe.-y �Ave � Everett <br />Ovmer Mailing Addrass o."T�� City <br />,,. �. _ <br />Same as above <br />Describe Proposed Work <br />s <br />Ac'dress <br />Drain ditch with <br />PROJECT ADDRESS (if known) 4938 <br />Date 1-17-96 <br />Public Works Permit N _���D/3 <br />Buildin9 Permit k � <br />Public Works Fee $ �._Q9 — <br />BK <br />Wp 96203 290-3163 <br />& gravel to divert rainwater runoPf awa <br />Attach tour (4) cop{es of plans tor proposed work - Draw to scaio and note the following if applicable: <br />•Property Lines 'Outline and dimensions of all ezistin9 and proposed structures on the lot •Existing and proposed utilities <br />�Centerline ol street •Indicate North 5how any proposed grading changes •Show measurements <br />PERMIT CONDITIONS: <br />1. All calls for inspection shall be made 24 hours in advance - phone 259-8810. <br />2. All work shall be pertormed in accordance with this permit and current City of Everett 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 />9. The City would recommend that the applicant consult a geotechnical <br />engineer regar;ing the proposed work. <br />5. The City assun�ae no responsibility by issuing this permit; it is l:he <br />owner's responsibility to determine what must be done to protect }�is <br />property. <br />6. Any disturbance to the slope should be minimized, owner should consider <br />staking the proposed pipe on the surface of the slope rather than bury it. <br />7, Rip-rap should be placed at the pipe outfall to prevent erosion. <br />� <br />O <br />V♦ <br />O <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undeisigned owner/applicant hereby agrees to hold and save harmless <br />the City of Everett from any and all claims for damagas, costs, expenses, or <br />causes of action that may arise because of installaliedfora dfunheracrees <br />theimprovementorotherright-of-wayuseheretoapp' 9 <br />to remove same upon notice trom the City and lo replace public property <br />damaged thereby. <br />� , <br />� t--�..�J- �r -; l- /8= �i <br />Signatura of Applicant � ua�e <br />COMPLEfION.RTtIIS ERMIT MA YBE CANCELLEDTBY HE CI7YIUPON ANY S�TOPPAGE OF WORK OSN TH S PROJEC 0 ER 90 DAYS DU`RATION.Y PUHSutu i v <br />