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i <br /> Date Mav�2 3• 19�3o PuLOc Woda Permil� `���4� <br /> � AppliCation FOr Biee�oeoi •�Qf�4FiA4 <br /> � <br /> PU�LIC WORKS P�RMIT °°°��°W°�k9FCe <br /> Totel Fee $ <br /> O p lessApol FcaPaa $ <br /> o O � .'f�.�o o O O o I n <br /> Pri�t or Typa Onl�i : Aa�A��ao�� a ZO— <br /> i U vi o a� o 0 0 o r:� .+ <br /> CJ P di � � d? w � � ,W O�] R <br /> P .t h N • <br /> UNIVERSE CONST.o �52° - 189t}n St �E Bothell 98012 481-3366 O <br /> Owner � ��� tiA�i1�gLA. _�s �i�"— Ciry Zip Phone `1 <br /> 'i r= J C�'u = rll � � 1— u =S .� [� L�i1 \ <br /> C.wner br � �i � .��"c a: o � g x�c � � :: � � <br /> Applicant Mai�ing Ar.dress City Zip Phnne � <br /> Describe Proposed Work New Sinqle Family Residence � <br /> ��- 14 W <br /> Projecl Address�il known) — �3� � 1 5T DiZ S� L <br /> r <br /> Attach four(4)copies ot plans lor proposed work• Draw to scale and note ihe lollowing as applicable: � <br /> • Properry Lines • Centerline ol street � <br /> • Outline and diriensions oi all ezisting and • Indicate Norih <br /> proposed structures on the lot • Show 2ny proposed grading changes <br /> • Existing antl proposed ulililies • Show measurements � <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1.All calis for inspection shall be made 24 hr;,in advance•phone 259-8810. � <br /> 2.All work shall be peAormed in accordance wdh Ihis permit and wrrent Ciry of Everett Design and Construction <br /> Standards snd Specifications. <br /> 3.Call Location Underground Service 48 hrs.before you tlig.TOLL FREE NUMBER 1-500•424•5555. � <br /> 4.ANY CHANGE IN THE DRIVSWAY CUT MUST BS APPROVED O <br /> BY THfi PUBLIC WORKS INSPRCTOR. <br /> 5.CONNECT DOWNSPOUTS TO PUBLIC DRAINAGfi SYSTSM. ` <br /> B.KREP CITY STREfiTS CLfiAN AT ALL TIMES_ � <br /> 7.bNY DAMAGS TO THF CURB AND SIDRGIALK WILL BE REPAIRED <br /> TO THE SATISFACTION OP THB PUBLIC WORKS DfiPT. O <br /> a <br /> F!1KNOWL[DGEMENT OP CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm� <br /> less the City of Everetl Irom any and all claims br damages, cosis, <br /> ezpenses, or causes of actior ihat may arise because of installation <br /> i� Q_ ��`G��_ �_ 1S„p�Q and maintenance of �he improvement or o�her right�ot�way use �.ereto <br /> applied �or ano fvrther grees to remove same upon notice Irom Ihc <br /> Approved br Construc ' �n Date Ci�y and re ace p � property damaged thereby. <br /> _� /�/f/� /`•r•�` —/"U � a / <br /> FINAL INSPcCTION Date �' 7J��'�S" <br /> ApproveA as Consiructed i ature ol 4p a Date <br /> everett PUBLICWORKSDEPAHTMENT WORK �UTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> � 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200Cedar5lreet BE DILIGENTLY PURSUED T� COMPIETION. THIS PERMIT MAY BE <br /> Everet4 WA98207 CANCELLED BY THE GTY Ui�ON ANY STOFPAGE OF WORK ON THIS <br /> Phonc:259�8810 PROJECT OVER 90 DAYS DUHATION. <br />