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Date 8-5-94 <br />Applicabon For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />TO POSTING " O q 19gR <br />Public Works Permit � <br />Bldg. DePI. s 45182 <br />Public Works Fee <br />Total Fee S <br />Less April Fee Pam S <br />Balance Due <br />Robert Brokaw PO Box 254 Everett 98206 259-6543 <br />Owner Malung Address City Zip Phone <br />Owner <br />Applicant Mailinq Address City Zip Phone <br />Describe Proposed Work <br />Lot 3 Short Plat 7-89 <br />Project Address (it known) <br />Attach four (4) copies of plans for proposed wore <br />- Draw to scale and note the following as applicable: <br />FLOG - .,_$699.00 <br />• Property Lines <br />• Centerline of street <br />PLBG <br />$98.00 <br />• Outline and dimensions of all existing and • Indicate North <br />proposed structures on the lot <br />• Show any proposed gradi19FA1ny(-s <br />$60.00 <br />• Existing and proposed utilities <br />• Show measurements <br />eLDG <br />$10.00 <br />BEL <br />DR. MY <br />PERMIT CONDITIONS 4000-79875 <br />1. All calls for inspection shall be made 24 hrs. in advance - phone 259.8810. SEWER $70.00 <br />2. All work shall be performed in accordance with this permit and current City of Everett DesigBkWBfbn9lt albr00 <br />Standards and Specifications. JJ Ejf' 194.50 <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1.800• �55 <br />4. Rooftop drainage shall be discharged: <br />t) to the site's ,:tom1 drain system ('private or public) <br />2) to a residential roof downspout system designed per section 4-9.4 of the city standards <br />3) onto splash !Aocks <br />Tile method selected will be subject to Public Works Departementapproval, <br />FINAL INSPECTION <br />Approved as Constructed <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA �3201 <br />Phone: 259-8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />() <br />Im <br />O <br />n <br />z <br />O <br />O <br />a <br />The undersigned owner/applicant hereby agrees to hold and save harm. <br />less the City of Everett from any and all claims for damages, costs. <br />expenses. or causes of action that may arise because of installation <br />and maintenance of the improvement or other right-of-way use hereto <br />applied for and further agrees to remove same upon notice Iron ,he <br />City at to reply public property damaged thereby. <br />Slgnatute of Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />