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.� <br /> Date 3 6 B6 a�ouc wmws Permu• ��6`�// <br /> Application For eiao DeO�� � 86/16.154 <br /> PUBLIC VI;ORKS PERMIT Puei,cWorksFee <br /> ,a�a�Fe, s_ <br /> Less ROG�Fea PeiO S_ <br /> �� <br /> Balance Oue S_ 2��� <br /> Print or Type Only _ <br /> �y r.... 1429 Sroadway EverPtt 98201 252-11e6 <br /> wner Mailing Address City Zip Phone <br /> J s D Builders _ 1429 Broadwav �rerett 98201 252-1166 <br /> Applicanl Mailing Address City 2ip Phone <br /> Descri6e Proposed Work _T]ew Sinql F m91y Ras,'dann� <br /> �zs W <br /> Project Address(if known) 9228 — lst Dr_ � S_R" � t�ezett � <br /> .1ltach four(4)copies of plans lor proposed work- Draw to scale and note fhe lollowinq as applicablc: � <br /> • Property Lines • Cenlerline ol streel � <br /> • Outline and dimensions ot all exis�ing and • Indicate Norih <br /> proposed slructures on the lol • Show any proposetl grading changes <br /> • Existing and proposed utililies • Show measurements � <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1. All calls for inspection shall be made 24 hrs. in advance• phone 259•881 5. � <br /> 2. All work shall be performed in accordance with this permit and current City ol Everett Design and Construction <br /> Standards and Specilications. <br /> 3. Call Location Underground Service 48 hrs.betore you dig.TOLL FREE NUM6ER 1•800•424•5555. � <br /> 4. ANS: GRADING DCNE ON THIS LOT SHALL BE DONE SO AS NOT TO IMPACT THE O <br /> ' SURROUNDING LOTS WITH RAINWATER RUNOFF, <br /> 5. DOWNSPOUTS FROM THE BUZLDING ARE TO BE TI,HT-LINED TO THE PUBLIC <br /> DRAINAGE SYSTEM, � <br /> G. ANY CURB & GUTTER CAMAGED DURING CONSTRUCTION SHALL BE REPLACED BY THE <br /> APPLICANT. 'w <br /> V, <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant herehy agrees to hold nnd save harm• <br /> less tPe Ciry ol Everett Irom any and all claims for damages, costs. <br /> �� expenses, or causes of action that may arise because ol installation <br /> ,� G� �� and rt aintenance ol the improvement or other right�ol�way use hereto <br /> applied lor and lurther agreas to remove same upon notice Irom the <br /> A ved or Co c ' n / Date City and to replace public proparty damaged thereby. <br /> � �167 ' �f <br /> FINAL INSPECTION Date <br /> �f�.� � � �-,.�-� <br /> Approved as Constructed Signature of Applicant Datz <br /> PUBLIC WORKS DEPARTMENT WORK AUTHCRIZED BY THIS PERMIT MUST BE STARTED WI'iHIN <br /> everett 180 DAYS OF �ATE PERMIT IS ISSUED AND THEREAFTER IS t0 <br /> � 3200 Cedar Slreet BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Evereti,Wf.98201 CANCELLED�Y THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259-8875 PROJECT OVER 90 DAYS DURATION. <br />