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/ <br /> SITE SUBDIVISION <br /> PUpiLIC W�RK3 PERII�IT Date: 6/10/2011 <br /> �� F'ublic Works Permit#: PW1106-014 <br /> C:ity of Everett Pup,��c,Works D=p;�rthi��tlll'k1ED) 11'QB guilding Permit#; B1105-017 <br /> T >, � 3200 C�,2(J�f,Street REf-1, �?31659 <br /> ���r 5=� Everett, v�A 98201 �Tlar�ninq Reference#: <br /> (425)j�(�;�F8�10;11�501_'! public Works Fee$: $ 25.00 <br /> t i;i;i3, 3�hJ.�5 Other $: <br /> � �`l� APFLICP�I��IAME AND ADDRESS: <br /> OWNER NAME AND ADDRESS: 1 ti � <br /> SHELDON DAVID M &JAN E TL ����"�••�� <br /> 2212 ROCKEFELLER AVE <br /> �L'RSD ��9�.i5 <br /> EVERETT WA 98201 <br /> PIiONE: <br /> PHONE: <br /> TAX PARCEL ID# 00439147802600 SITe ADDRESS: 2212 ROCKEFELLER AVE <br /> DESCRIPTION OF PROPOSED WORK: <br /> DETACHED GARAGE <br /> PERMIT CONDITIONS <br /> 1. All calls for inspection sf.all be made 24 hours in advance. <br /> 2. All work shall be performed in accordance with the permit and current City of Everett Design and Construclion Standards <br /> and Specifications. <br /> 3. Call Location Underground Service 48 hrs before you dig. TOLL FREE NUMBER 811 <br /> 4. The contractor must meet with the Public Works Inspector to discuss potential drainage routing prior to beginning W <br /> the project. Call Randy Allen at 425-339-7403 E.,i <br /> 5. No dirt, mud, rocks or debris to be tracked onto roadway. r.r <br /> � <br /> � <br /> "� <br /> z <br /> 0 <br /> � <br /> 0 <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> �D �� S^r �� G I 1 _ .L � _ �' The undersigned owner/applicant here6y agrees to hold and <br /> save harmless the City of Everett from any and all ciaims for <br /> damages, wsls, expenses,or causes of action that may arise <br /> because of installation and mainlenance of Ihe improvement <br /> ` / ,('c_ ��-_ � ,��;,�/ or other righ4oLway se here applied for and funher agrees <br /> T `/' lo remove same up n notic rom lhe City and lo replace <br /> App e r nstru tyon � Date pu c p pe y d aged ereby. <br /> ' �C�� �/3- �`�� ��� <br /> FINA� INSP TION Date <br /> Approved � Constructed Signature o(Applicant Date <br /> l'JORK AUl"HORIZED BY THIS PERMIT NUST BE STARTED WITHIN ISO DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS TO BE DIUGENTLY <br /> PURSUED TO CODIPLtTION. THIS PER�IIT�1AY OE CANCELLED 8Y THE CIiY UPON ANY 5TOPPAGE OF VJORK ON THIS PROJECT OVER 90 DAYS DURAT70N. <br />