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Date ��_6�46 ' � PutlrcWorksPermn• V v''//G <br /> Fpplica+�on For aiao-oec�.. g6 16169 <br /> PUBLIC WOF��CS PERMIT PueToteFee�e� s <br /> , j lesa/Oo�Fea Pond s `� <br /> Print or Type Only � Balenca0ue S Q= _ <br /> Boyden Realty, Inc. 1429 Broadway Everett 98201 252-1166 <br /> Owner MailingAddress Cily Zip Phone <br /> J & D Builders 1429 Broadway �Verett 98201 252-1166 <br /> Applicant Mailing Address City Zip Phone <br /> Describe Proposetl Work NEW Si71c�'Le Family Residence <br /> �0-�- / � � <br /> Proleal Address(ii known) — tt � <br /> Attach lour(4)copies of plens for proposed work- Draw lo scale and note the lollnwing as applicable: � <br /> • Property Lines • Centerline of street � <br /> • Outline and dimensions o1 all existin�and • Indicate North <br /> proposed structures on tha lot • Show any proposed yra�ing changes <br /> • Existing and proposed utilities • Show measurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS O <br /> 1. All calls lor insuection shall be made 24 hrs.in advance� phone 259•881 5. � <br /> 2. All work shall be pedo�med in accordance with this permit and cunent City ol Ever�tt Design and Conslruction <br /> Standards and Specifications <br /> 3. Call Location Underground Service 48 hrs. belore yuu dig.TOLL FREE NUMBER 1•800•424•fi555. � <br /> 4. ANY GRADING DONE ON THIS LOT SHALL BE DO[iE SO AS NOT TO IMPACT THE O <br /> SURROUNDING LOTS WITH RAINWATER RUNOFF, <br /> 5. DOUNSPOUTS FROM THE BUILDING ARE TO BE TIGHT—LINED TO THE PUBLIC DRAINAGE <br /> SYSTEM. � <br /> 6. ANY CURB & GUTTER DAMAGED DURING CONSTRUCTION SHALL BE REPLACED BY THE <br /> APPL ICANT. //� <br /> \/♦ <br /> O <br /> a <br /> AGhNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm• <br /> � less the Ci1y of Everett Irom any and all claims lor damages, costs, <br /> ��� J �v // expenses, or causes ol action Ihat may arise Gecause ol installation <br /> � � AF� and maintenancr. of the improvemen� or other right-of�way use hereto <br /> A�roved for C�n`r� ier �E p�� applied for anC lurther agrees to remove same u�on nolice Irom tLe <br /> City and to repl ce public property damaged thereby. <br /> �-� ,.......-; _ ���l7 �� (� �' -� � .� ,�'� <br /> FINAI WSPECTION Date <br /> Approved as Constructed Signatur��ol Applicant D te <br /> everett PUBLIC WORKS DEPARTMENT WORK AUTHORIZ[D BY THIS PERMIT MUST BE STARTED WITHIN <br /> � 3200CedarStreet 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett,WA 98201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone: 259�8815 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 50 DAl'S DURATION. <br />