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Pus�ic woRKs <br />PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Evcretl, WA 98201 <br />(425) 257-8810 <br />OWNERNAME �1 NqU]lNll <br />ANDADDRESS: <br />934 Glenliaven <br />EVERETT <br />i HONE: Qj5?.5>%(11�7 <br />TA% PARCELi.O.« <br />DESCRIP710NOF D[1VP_wdy <br />PROPOSE� WORN: <br />PERMIT CONDITIONS <br />Date ln,+lii,��nn�s <br />Public Works Pn,tmil N pp0310-008 <br />Building Permit a <br />Planning Reference a <br />Public Works Fee S 5�5.00 <br />GuaraMcc S <br />APPLI"ANTNAME pim N� u Fn <br />ANDADDRESS�. I Y- <br />W �8203 <br />rr+oNe: <br />FPOJ[CTADDfiESS: 1B1? MCDO <br />1. All calls for inspection shall be made 24 hours in advance • phone (425) 257•B810 <br />2. All work shall be perlormed in accordance with Ihis permit and current Ciry of Eve�etl Design and Conslruction <br />Standards and Specificalions. <br />3. Cali Location Underground Service 48 hrs. befom you dig. TOLL FREE NUMBER 1-800-424-5555 <br />4. Contact inspectoi at 9'S-339-1903 foc consultation pcic�[ to st.arting wurk. <br />5. Lnstall deive�ay cut vith apcun - Femuve and Faplac.� 4 inch aidc�.+alk in dcLveway <br />ar�a to fi inch ttiickness. PavF th-r diivevay feom the sidevalk to at least 20 teet <br />i>eliind the fcont pcoperty line. <br />n. This dciveway ia f.r eesidential use only. The drit�zvay ahall De cemo•�ed if the <br />pe��perCy is put t„ r,imnecci.,l u�e. <br />�lhy5 ntic ���r�-'-� _�-�v1_t.. ML <br />�p ��"10'03 <br />Ap mvetl lor Cons+rustion Dale <br />„/ r_ <br />C�l,��r �' 2��<<<— 3—"7-��� <br />FINAL INSPECTION <br />I Approved as Constmcled Dale <br />A OM4933 <br />10-10-03 S:Sc^PM <br />q 0310006 <br />OTHER 25.00 <br />TOTAL 25.00 <br />� <br />W <br />F- <br />� <br />N <br />W <br />O <br />� <br />Z <br />O <br />F- <br />N <br />� <br />a <br />CASH 30.00 <br />ACKNOWLEDGEMENT OF CO�VS 5.00 <br />A OM4933 <br />7he undcrsigned owner/applicaN heroby agrees to hold and <br />save harmless Ihe Ciry of Everett irom any anA all claims lor <br />damages, costs, expenses, or causes oi action Ihat may arise <br />because ot inslallation and maiNenance of the irt�orovement or <br />other righl�of�way use herclo applied tor and further agrees to <br />remove samo upon notice trom the Ciry and to replace public <br />property damaged th�reby. <br />/ /o p <br />Sig ur Applkant Date <br />WORK AUTHORIZED I3Y THIS PEN�d1T MUST 8G S7ARTE0 WITHIN 180 DAYS OF DATE PERMIT IS ISSUEO AND THEREAFTER IS TO BE DILIC�ENTLY PURSUEU <br />TO COMPLETION THIS PEfiM1T h1AV OE CANCELLED 6Y THC GTV UPON ANY STOPPAGE OF WORK ON THIS PROJECTOVER 90 DAYS DUFATION <br />