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J � ���g� PuO��c Works Permit� 4��� <br /> Date 6'g'93 e�ea o�o� ._ <br /> qpplicationFor publ¢Work�Fea s—__ <br /> • �pUg��C WORKS PERMIT ToteiFee <br /> Lesn POC�-Fee PUC s-- <br /> TO P(►STING �� �s-9"� a.,.���o�� _ '�— <br /> Print or Type Only <br /> y Z�P Phone ( �� <br /> Adventure Const Z MaiHng Address Ciry �� <br /> Owner \ __ <br /> QWner ZiP Phone <br /> ppplicant <br /> Meiling Address City <br /> Describe Proposed Work <br /> new houae <br /> I � � , .� W <br /> -_ . �"' <br /> Prolecl Address(il known) � <br /> Atlach tour(4)copies o1 plans for proposed work- Draw to scale and note the�ollowing as applicable: � <br /> • Centerline ol street <br /> ��� • Property Lines • Indicate North <br /> �, -. • Outline and dimensions of all ezisting ana � Show any proposed grading changes � <br /> � proposed stmclures on the lot � Show measuremenls <br /> 1 Exisling end proposed utili�ies O <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS � <br /> 1.Alt cells for inspectbn shell be mede 24 hrs.fn advance•phone 259•8810• <br /> 2.All work aheil be pertormed in accordence with this permil end cunent City of Everett Design end Construclion � <br /> Standards and Specifications. 24•5555. <br /> 3.Cell Location Underground St+rv�ce 48 hra.before You dig.TOII FREE NUMBER 1'B0�'4 O <br /> 4. Install rock canstruction entrance behind driveWaY ae Per city <br /> atandard f�208 and erosion control as directed bY ['ublic Works <br /> Inapector. � <br /> 5. Keep city atreata clean at all times � <br /> 8. �b gutter and sides�alk in the plat are new and undama�ed. <br /> �y damege thereto ahall be replared at the discretion of the <br /> public Worka InePer_tor. the py� In O <br /> 7, pny chanBe in the driveway cut muet be approved �'ron Width. <br /> 8pector. width at prop line limited to existinR P � <br /> e, Connect all roof. yard and driveWay drains to atorm drain <br /> system provided to lot. <br /> g, pd.ivat water bo�8 �oIDpietelYtcured before driving on them. <br /> 10. DriveNaYs shall t�e <br /> ACKNOWLEDGEMENT OF COND�TIONS <br /> � The undersigned owner/applicaN hereby agrees to hold and save harm� <br /> � — less the Gily of Everett irom any and all claims br tlameges, costs. <br /> � I/^ ��� ezpenses, or causes of action that may arise because of installalion <br /> /1 /� �y and maintenance of the improvement or other right•ot-way use hereto <br /> �/�/i O /�L1 apPlied f r and further agrees to remove same upon notice Irom the <br /> [.�/� -� � " � Date City ai� o replace public perty damaged thereby. � <br /> qppro e for C truction <br /> ��u -93 Dete <br /> Date licant <br /> FINAL INSPECTION �gn ture o APP <br /> qpproved as Constructed yypRK AU HORIZED BY THIS PERMIT MUST BE STARTED WITH <br /> PUBLICWORKSDEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> � 32o0CedarStreet BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Everelt,WA 99201 pROJECT OVER 90 DAYS OURATION.ST�PPAGE OF WORK ON THIS <br /> Phane:259�8810 <br />