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Date ��-�S-�3 �- I -L�� PuEI¢Worka Pe�mlt� � J � � <br /> ApplicationFor TO POSTING sa�-9 eiao.oeo�.• 41407 <br /> PUBLIC WORKS PERMIT PuELCWork3Fee <br /> Totei Fee f <br /> Less Rppl.Fee PaiE S <br /> Print or Type Only Belenca0ue s 7�P1' _ <br /> � <br /> � <br /> Select Homes 237 Elm St Everett WA 96203 258-1503 <br /> Owner Mailing Address Ciry Zip Phone <br /> OWR2i <br /> ApplicaM Mailing Address City Zip Phone � ` <br /> �C) <br /> Dascribe Proposed Work new house � � <br /> �-.0 <br /> W <br /> Proiect Address�il known) 5429 lst Dr W Lot 25 Hanabrook 4 � <br /> Altach lour(4)copies ol plans for propo�ed work- Draw to scale and note the lollowing as applicable: � <br /> • Property Lines � Centerline of sireet � <br /> • Outline and dimensions of all existing anA � Indicate North <br /> proposed structures on the lot • Show any proposed grading chonges <br /> • Existing and proposed utilities • Show measuremenis � <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1.All calls for Inapection shall be made 24 hre.in advance•phone 259-8810. � <br /> 2.All work shall be performed in eccordence with this permit and current City ol Everett Design and Construclion <br /> Stendards and Speciflcaticna <br /> 3.Call Locatlon Undergraund Service 4B hrs.before you dig.TOLL FqEE NUMBEN 1-800-424•5555. � <br /> 4. Install rock construction entrance behind driveway as per city <br /> standard it208 and erosion cuntrol as directed by Public Works O <br /> Inapector. <br /> 5. Keep city atreets �lean at all times <br /> B. Curb gutter and aidewalk in the plat are new and undamaged, � <br /> any damaqe thereto ehall be replaced at the diacretion of the <br /> Public Worka Inapector. � <br /> 7. Any change in the drivewa;� cut muat be approved by the PW In- <br /> epector, width at prop line limited to existing apron widtb. O <br /> 8. Connect all roof, ,yard and driveway draine to storm drain <br /> syatem provided to Lot. � <br /> 9. Ad,ivat water boxes to grade at end of conatruction_ <br /> 10. Driveways ahall be completely cured before driving on them. <br /> �Or ACKNOWLEDGEMENT OF CONDITIONS <br /> ��/" <br /> The undersignetl owne�/applicant hereby agrees to holtl and save harm� <br /> less the City ol Everett Irom any and a�i claims for damages, costs, <br /> ///��� // ^ ` ,�1 ' / � r� expenses, or causes of action Ihat may arise because of installation <br /> �� L and mainlenance of �he improvemen� or other riyht-of•way use hereto <br /> C,cJ�— N v y <br /> Approved r Construc wn Date applied lor and lurther agrees to remove same upon noUce frnm Ihe <br /> Ciry a d repl e blic properry dam d ihereby. <br /> .�/� 5//-�_ Z - <br /> FINAL RJSPECTION Date � <br /> Approved as Construcled Signatu e ol Applicant Date <br /> � PUBLIC WORKSDEPARTMENT WORK AUTHORIZED BY THIS PEHMIT MUST BE STARTED WI?HIN <br /> 3200CedarStreet 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett,WA98201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone:259�8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />