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Date 8-5-94 <br />Applicalion For <br />PUBLIC WOFiKS PERMIT <br />Print or Type Only TO POSTING �/ ��� <br />Robert Brokaw PO Box 254 Everett 98206 259-6543 <br />Maihnq Ar.dres5 <br />Owner <br />APPlicant �:� ��6�-�:: nddr��;s ---'------ <br />Describe Proposed 4Vork new house <br />2 Short Plat 7-89 <br />cn� Z�n <br />Z�o <br />Pubhc WorkS Pnrmil � ��/,_��� <br />�- <br />nnin ocoi . �5�1 ___— <br />F,��,����vo,�,�„� S -- <br />,o�.� Fe� _ <br />less 4nn� fni. pr�.�] S <br />� <br />e;,�.,��„n�� s �—__ <br />Project Adtlress (il known! Z�Z �O_ n[�_!�' V�! ��A ��a______._ �g/�f1/�4 t. <br />Attach four 141 coPies of plans fo� nroposed wmk � Drav: to >c.ii., .�::,y note tn��'oiloiviny as apUlir.ahie: � <br />• Property Lines <br />• Ou�line and dimensions of all exi5ting anA <br />proposed siructures on the tot <br />• Existino and proposed utilities <br />Phqnc <br />Phone <br />• Centerhnn nf s�reet ��'S181 <br />• �ndica�e Narih ELDG f723,50 <br />• Shox� any r.rcooseA c�radirj2��nyes S96,Op <br />• Show measurements MECH SEO.� <br />E <br />...............���"... ,.....".� <br />sec►�c sa.so <br />PERMIT CONDITIONS DRIVN�1 4c0.Q0 <br />1. All calls for inspection sha�l be made 24 hrs. in advance - phone 259•881 O. q00029876 <br />2. All work shall be peAormed in accordance vrith this permit and current Ciiy ot Everetl Desig�Constr��n� <br />Standards and Specifications. �� g�G� .,ZZ � <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•8W�4Z��5� ` <br />4. Rooftop drainege ahall be diecherged: CHEGt. S c19. � <br />1) to the aite's etortn drein syatem (priva[e or public) <br />2) to e resideMiel rooC downapout syatem designed per aection 4-9.4 of the city atenderda <br />3) ento epleshblocke <br />The method aelected will be cubject [o Public Wor{:s Depertement approval. <br />� <br />..___ __._—I <br />// _ n.��� /7 �.._ � � ; <br />� <br />Approved as Consiructed <br />�PUBLIC WORKS DEPARTMENT <br />3200 CederStreet <br />Everett. WA 98201 <br />Phone: 259•8810 <br />. 3' >1' <br />��v� <br />ACKNOVdLEDGEi "�NT OF CONDITIONS <br />W <br />� <br />� <br />� <br />� <br />O <br />� <br />� <br />O <br />a <br />1 he undersianed owneUappllCan e�eby agrees to holtl and Save harm� <br />less ;he Giy of Everett imm ar, and all claims for damages, cosis. <br />pwP�nses or causes ot action that may arise hecause ol insiallation <br />ann maintenanr,e n! ihe improvement or other righPohway use hereto <br />a;�c����cr! lor nnd furth^r agrees to remove same upon notice Irom Ihe <br />C:': a, 1 In repla puulic property damaged Ihereby. <br />Siqn. ure o AnPlicant Date <br />IVORK AUTHORIZED BY iHIS PERMIT MUST B STARTED WITHW <br />1H0 �AYS OF DATc PERMIi' IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLI' PURSUED TO COMP:ETION. THIS PERMIT MFY BE <br />C.4NCELLEU BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PRO.IECT O'JER 90 DAYS DURATION. <br />