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_.. . <br /> DBtB 3�6�86 . .- Pueucworweaerm�it• Cl(0���-3 <br /> Ap{:dication For <br /> eioa.oeo�.• 86/161�3 — <br /> PUBLIC WnRt�S P�RMIT PUEI¢Work�Fee <br /> m�.i voe s <br /> Lass aoo�Pou Poid 5 <br /> Print or Type Only B�"�"��° s 2� <br /> Boyde•: :tealty, T_nc. 1429 Broadw�l Everett 98201 252-1166 <br /> Owner Mailing Address Cily Zip Phone <br /> D & J Builders 1429 Broadway Everett 98201 2`;2-1166 <br /> Applicant Mailing Address City ,Zip Phone <br /> Descrioe Proposed Work New Single Family Residence <br /> -- . W <br /> Proje�t Address(if known) - � <br /> Attach four(4�copies of plans lor proposed work-Drew to scale and note Ihe following as applicable: � <br /> • Properry Lines • Centerline ol street � <br /> • Outline and dimensions oi all existing and • Indicate Norih <br /> proposetl structures on the lot • Show any proposed grading changes <br /> • Exisling and pruposed utilities • Show measuremenis � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS O <br /> 1. All calls for insFeclion shall be made 24 hrs. in advancr.• phone 259•8815. � <br /> 2. All work shall bn.performed in accordance with ihis permit and current City ot Everett Design and Constru:tion <br /> Standards and Specifications. <br /> �3. Call Location Underground Service 48 hrs. belore you dig.TOLL FREE NUMBER 1•800•424•5555. � <br /> 4. ANY GRADING DONE ON THIS IAT SHALL BE DONE SO AS NOT TO IMPACT THE O <br /> SURROUNDING LOTS WITH RAINWATER RUNOFF, <br /> 5. DOWNSPOUTS FROM THE DUILDING ARE TO BG TIGk:T-LINED TO THE PUBLIC <br /> DRAINAGE SYSTEM. � <br /> 6. ANY CURB & GUTTER DAMAGED DURING CONSTRUCTION SHALL BE REPLACED BY THE <br /> APPLICANT. � <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm• <br /> .; — � less the City of Everett from any and all claims tor damages, costs. <br /> expenses, or causes ol aclion that may arise because ol installation <br /> ���� v and maintenance ol the improvement or other right-ol•way use hereto <br /> apphed lor and lurther agrees to remove same upon notice I�om Ihe <br /> A oved f�Q6n� ion ,� Date City and to replace public properiy damagetl thereby. <br /> . ��`� , <br /> FINAL INSPE�N ���-� Date ���'`�"� �� ��� � �f � <br /> Approved as Constructed Signature ol Applicant Date <br /> everett PUBLIC WOf7KS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STHRTED WI7HIN <br /> 3200CedarStreet 180 DAYS UF DATE PERMIT IS ISSUED AND THEREAFTEfi IS TO <br /> I� BE DILIGENTLY PURSUED TO COMFLETION. THIS PERMIT MAY BE <br /> Everett,WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone: 259�8815 PROJECT OVER 90 DAYS DURA?ION. <br />