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� I'��— • puol¢WotMs Parmlt• �f � / <br /> A I I1Sl./ <br /> 7�(J'%� eioa oeo�..�—�-�'r <br /> pate_�3 TO PQSTING_ <br /> qpplicetion For Fu�Lc WorksFea s_—� <br /> RKS PERMIT Tote�Fee <br /> PUBLIC W� «„�oo,Fa�P.,as--- <br /> Balance Due s�v- <br /> ��1 <br /> Print or 7yPe Only <br /> 98007 644-2323 pho�e <br /> 14410 Bel-Red Rd d200 Bellevue�WA Zip <br /> Colony CiBft Mai4ingAddress <br /> Owner �� <br /> Z.P Phone .,\ <br /> Ciry `CJ <br /> p�[ter Maili�g Address '� <br /> APPlicant N <br /> new house <br /> Describe ProPosed W��k � <br /> O 8 � <br /> � <br /> 5615 lat Dr SE 9 licabie: � <br /> Pmle��Address 1if known) � Ce��yrline of slieet <br /> Attach four(4)copies ot Plans for proposed work-Draw 10 scale and note Ihe tollowin as app <br /> rt Linas • Indicate NoAh radin9 changes � <br /> • Propa Y • Show anY ProPosed 9 <br /> � OuUine and dimensions oi ell existin9 ar'd � ghow mexsurements <br /> proposed slru fou�osed ulilities O <br /> • Existing and p P <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS � <br /> 1,All calls tor Inapection shell be mada 24 hrs.in edv�noe'Phone 259'881 � <br /> rmit end current CNY ot Everett Desfgn end Constructfon <br /> TOLL FREE NUMBER 1'800'424•5555. <br /> 2.All work shell be performed in accordence wilh this pe <br /> Standardsa^dSpecificetfons. r City O <br /> directed bY �blic Worke <br /> conetruction entranoe 1�ehind driveaaY � � <br /> 4 C Inet911 rnook round Servlce 48 hrs.before You <br /> 8t��ra g2pg and eroeion control as � <br /> InsFb�tor. d undamaBed, <br /> 5. KeeP citY at�eta clean at all t�8t �,e n� � � <br /> 6 �rb gutter and eides�alk in the P <br /> �Y d�ge thereto ahall be rePlgced at the discretion of the <br /> ctor. a roved bY the PW In' O <br /> public Works I�Pe g ron width. <br /> 7. MY c�Be in the �'iv�ineclimitea o e pstittB p drain /� <br /> epector. width at prop a driveaaY draina to etorm `i� <br /> g. Connect rovid dito lot-� <br /> eyateID P gde at end of conatruction-on them. <br /> 9. Aa.ivat Wgter �xeB completely cured before driving <br /> 10. Dri��°ye ahall be <br /> ACKNOWLEDGEMEN7 O e�o e�io!Oold and save harm- <br /> licant hereby 9 es, costs, <br /> e The undersigned ownerlapP and a11 claims for damag <br /> ^�d less lhe CdY of Everett irom anY arise because of installation <br /> `JJ�, use herelo <br /> t� expenses. or causes of action that ma <br /> rees to remove same uPon notice Irom the <br /> � , �U3 and maintenance ol Ihe improvement or other right•o�weY <br /> �7 � � � �� applied Icr and further ag damaged thereby. <br /> .//�_ /;�� lace Public ProPerty . <br /> Y /,e!!X/ Date CitY and to reP �. �� <br /> �—Y— !�/� <br /> APProved for Constru C/ � � y Date <br /> - 7-/1 l,w� <br /> ` a1e ' ature ol ApPlicaM <br /> FINAL INSPECTION WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 180 DAYS OF DATE PEFMIT IS ISSUED AND THEREAFTER IS 70 <br /> qpp�pved as Construcled COMPLETION.THIS PERMIT MATHIS <br /> PUBLIC WORKS DEPARTMENT gE DILIGENTLY PURSUED TO <br /> CANCELLED BY THE CITY UPON ANY SSOPPAGE OF WORK O <br /> � 3200 Cedar Street PROJECT OVER 90 DAYS DURATION. <br /> Everetl,WA 98201 <br /> Phone:259'8810 <br />