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� ' I <br /> ��� Date 8/12/91 . F� -'�� 28-`{' P�o���wo��sv�,91/2 511�3U4 <br /> eiaa oen� • <br /> Application For <br /> ��� PUBLlC WORKS PERMIT °°°"°w°'"„`° $ _ <br /> inu�Pan <br /> � Lesa Appl Fee PaiU S <br /> p G� , C. �l� G Da�anceDun $ Z�— <br /> �I��II Print or Type Only ��� � �' �� <br /> ��� ` � ,� �, � �� �;; TO PQSTING---�/' � <br /> � -� r� � QeZ_. <br /> Qy Select i;omes Inc 2�7 Elm St EvereCL 4�203 ��258-1503 <br /> 0�"� eilin ; ddr '� �� ' _ . Ciry Zip Phone <br /> �y�� Owner � r M ,9q �r�� �ii.� . <br /> i � .r O W l ri � , r] <br /> 4-i �� . � . ri 1- -i � r p i,i OJ <br /> QY O ...I 1 I .� '1 C _ ( ] I I � <br /> � I 0.i L C] :: S ['l -' 1 -� r-: <br /> N Zip Phonc <br /> y y� ppplicant Meiling Adt'ress ���Y I . � <br /> t.� \T� <br /> M• <br /> � ci e f�mil rt+w <br /> �� Describc Proposetl lNork __.�-�YL 115� Y <br /> O� rr <br /> � 1 W <br /> � <br /> ProlEcl Adtlrc;:s(if known) U� 1 '- (5 t. 171Z S� Lo 1' � 2-3 �1 V ( ` <br /> r <br /> Fnach four(4)copies M plans�or proposed work-Draw lo scale and note the following as applicabte: �� I <br /> • P�operry Lines • Centerline of sireet /A <br /> • Oulline antl dimen�ions ol all enistin�and • Indicate Norlh V� <br /> proposed slrutWres on Ne lol • Show any proposed grading changes <br /> . � • Exisling and p�oposeA utilities • Show measuremenis /�/� <br /> W <br /> DO NOT WRITE BELOW THIS LINE O <br /> i \\r <br /> I C', PERMITCONDITIONS <br /> � 1.All calls br inspection shall be made 24 hrs.in advance�phone 259•8810. � <br /> ; 2.All work shall be peAonned in accordance with this permit and current Ci�y ot Everett Desiqn and Construction <br /> Standards and Specilications. <br /> �� 3.Cull Lota!ion Unde�ground Service 48 hrs.belore you dig.TOLL FREE NUMBER 7•800•424-5555. � �� <br /> � �i ��� 4 , Install rod�-. construrtion entrrance 6eliind driveway as Per cit�� A <br /> � standard 7.�iiFJ nnd -.rosi.on cor�trnl :.i-�� di.rer.ced by Fublic WorF�.= � <br /> , Inspector. '� <br /> : i '��. '.�. M::eep city =treets cl�•_,n at all times f <br /> ��� G. CurS qutter and side��alk. i.n the plat ar� new and �incf�,maaed . � � <br /> -.iny damaqe i.hareto shall be replaced at the discret.ion �f +-.r��_� � <br /> ' Fub] ic Worl:.s Insni=cY.or. � <br /> ' 7. Flny chanqe .in the dri.vewav nrt miist be approved bV the F'ubli.c � <br /> I �.�� Works Insoer.toi�. <br /> � B. T.iqhtli.ne all roof. /�rd and drivei�iav drains to stor-m drai.n � <br /> sti.ibs at back side of sidewal6:. <br /> � `. !Vd {iist watc�r bo::es lo qr-arle at end oi� �_onstri_ictinn. �—� <br /> I ��� 1,�,. I)r-.i.�rw.r�s �.I�-,77 hr c�,nn>1 �,��,cl �; curcd I�cfoi� � dr- i.vin0 on them. <br /> I ACKNOWIEDGEM" C�FGONDITIONR <br /> Theundersignudowncr/applicant' .7��rees�ohold..nJsaveharnr <br /> �_1 � - less ihe Gi�y of Everett from ar , � all claims for nainages. casts. <br /> � <br /> eapenses, o� causus of action ;' �p arise because ol inslallation <br /> - �C� �rn��' 8 ,��_pJ� and maintenance ol Ihe imprrnr �, o' other ric]hl-al-may use hereto <br /> apP�ied br nnd turther agmos h .�iove same upen nolice iwm �he <br /> Appmved for Construction ���� City anA to replace public property damaJed thereby. <br /> ��; �.i!-�_� �_�L ' /` _ Q <br /> fINALINSPECTION Uatc �`�a��— _ I- 7"9��_ <br /> Approvetl as Constructed Si9natwo of Applic nt Date <br /> �� PUBLICWORKSDEPARTMENT WORK AUTHORIZEO BY THIS PERMIT MUST BE STARTED WITHIN <br /> 180 D�YS OF DATE PERMIT IS ISSUED AND THEHEAFTER IS 10 <br /> 3200Cedar5lreel 8E DILIGENTLY PURSUED TO COMPLETION.TIiIS PERMIT MAY BE <br /> EveretL WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORIC ON TNIS <br /> Phone:259-BB10 PROJECT OVER 90 D�YS DUflATION. <br /> � <br /> __-_-'_ ~ ... <br />