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f �uB�ic woRKs <br />PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Stroet <br />e�aren, wn se2oi <br />`'z��s�-�b�STING il-u-ot <br />ANDADORESS:BLUL QIDGE CONSTRUCTION <br />PO BOX 30:? <br />DWALL W� 98019 <br />�+oNe: ( 306 ) 819-7413 <br />TA%PARCELI.D.� gg���_000-021-0004 <br />DESCRIPiIONCF rjJ„i'j�j )[OUSE — B�SIC L05� <br />PROPOSED WORK: <br />PERMIT CONDITIONS <br />APPLICANi NAIAE <br />AND ADDRESS: <br />PHONE: <br />Date <br />Public Works Pertnfl N <br />Building Permit N <br />Planning Reterence M <br />Public Works Fee S <br />Guarantee $ <br />PROJECTAD�R[SS: �j3�2 N1IRBECK 11Vfi <br />LAT 21, EA6LE FALI.9 <br />03/?:!,�20C9 <br />PW0083-fo58 / <br />C0003-e18 <br />$ 25.00 <br />� <br />t. All calls (or inspection shall be mode 24 hours �� advance - phone (425) 257•8810 <br />2. All work shall be performed in accordance with ihis pertnit and current City ot Everett Design and Construction <br />Stand�rds and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FflEE NUMBER 1-800-424•5555 <br />4. Keep city streets clean at all times. Wl� <br />5. Curb qutter and sidewalk in the plat are new and undamaged. ?,iiy 1— <br />damaqe thereto shall be replaced at the discretion of the Public Works � <br />Inspactor. <br />6. Prior to any change in the driveway cut, approval must be obtained <br />from the PW Inspector. Width of driveway at property line is limited to O <br />the existinq apron width. -00 10:43AM <br />7. ]ldjust water boxes to grade at end of construct �� ' <br />8. Driveaays shall be completely cured befor•a dri on <br />9. Rooftop drainaqe shall be discharqed to the st �ra���i stub <br />provided at the front of the lot. SRCHG 4.50 <br />DRIVE f.5.00 <br />PLUMB 91.00 <br />i1ECH 80.00 <br />q 0003030 <br />WATER 130.00 <br />SEWER 70.U0 <br />IiTILITY 1613.00 <br />TOTAL 3'.58.45 <br />A OM6619 <br />CHEK 3158.45 <br />ACKNOWLEUGEMENT OF COND!TIONS <br />The undersigned ownedapplicant hereby agrr.es to hold and <br />save harmless Uie Cly of Everett hom any and a:� claims for <br />damages, costs, ezpenses, a causes ol aclion Nwt may arise <br />because installation and maintenance of the imp�ovement or <br />other rig �ol-way use herero applied for and furtlier agrees to <br />remove u noh�/�Ihe Cjl/and to repla:e public <br />P�nY fl � ? <br />� � d z��/�eRiO <br />SlgneturodMpliteM oate <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WIiMIN 180 OAYS CiF OA7E PERMIT IS ISSUED AND THEREAFfER IS TO BE DIIICaENTLV PURSUED <br />TO COMPLETION. THIS PERMIT MAY BE CANCELLED BV THE CITV UPON ANl STOPPACaE OF WORK ON TMIS PRQIECT OVER 90 DAVS WRATON. <br />