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LL 15-93 � ` —��,t —� PUEtieWorkaPermit• I S/� <br /> Date_= TO POSTIIIG S "1�-�`� 1 <br /> eiap oeo��• <br /> Application For <br /> PUBLIC WORKS PERMIT PubTole ae"° _ — <br /> Leaa NOP�Fee PaiE S <br /> Balanca Due S �� <br /> Print or Type Only <br /> Select Homes 237 Elm St Everett WA 98203 258-1503 <br /> U <br /> Owner Mailing Address City Zip Phone <br /> Owner <br /> Appiicant Mailing Address City Zip Phone � <br /> < <br /> Describe Proposed Work neW hause -{. <br /> . W <br /> ProlectAddress�ifknown� 5515 Ist Dr W Lot 29 H � � <br /> Attach lour(4)copies ol plans for proposed work• Draw to scale and note the foilowing as applicable: �� <br /> � Property Lines • Centerline of streel � <br /> • Outline and dimensions of all existing and • Indicate Norih <br /> proposed structures on the lot • Show any proposed greding changes <br /> • Existing and proposed utilities • Show measurements M <br /> W <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1.All calls for inspectlon ahall be matle 24 hrs.in edvance•phone 259-8610. � <br /> 2.All work shell be pedormed in eccordance with this permit and curteM City ol Everetl Design end Construction <br /> Standards and Speclficetions. <br /> 3.Call Locatlon Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1•800-4245555. � <br /> 4. Install rock cons+.ruction entrance berind driveway as per city <br /> atandard #208 and erosion control as directed by Public Worka � <br /> Inspectur_ <br /> 5. Keep city atreets clean at all times <br /> 6. Curb gutter and sidewalk in the plat are new and undamaged, � <br /> anY damage thereto ahall be replaced at the discretion of the <br /> Public Works Inspector. � <br /> 7. Any change in the driveway cut muat be approved by the PW In- <br /> spector, width at prop line limited to existing apron width_ O <br /> B. Connect all roof, yard and driveway drains to atorm drain <br /> system provided to lot. a <br /> 9_ Adjust water boxea to grade at end of construction_ <br /> 10_ Driveways shall be completely cured before driving un them. <br /> �(�_ ACKNOWLEDGEMENT OF CONDITIONS <br /> ^ r7 <br /> �� The undersigned owner/applicant hereby agrees to hold and save harm• <br /> _. less the C�tY ot Everett irom any and all claims for damages, costs, <br /> ��� � N� �y 93 ezpenses, or causes of action that may arise because ot installation <br /> and maintenance ol the improvemenl or other right�of•way use hereto <br /> applie 1or and turther agrees to remove same upon notice irom the <br /> Approved for Construction Date �i�y re lace blic propert maged thereby. <br /> �-�-- s-i�- �'y ll-zY-93 <br /> FINAL INSPECTION �a1e �" Date <br /> ppproved as Constructed Signatu ot APPlicant <br /> WORK AUTHORI2E0 BY THIS PERMIT MUST BE STARTED WITHIN <br /> � PUBLICWORKSDEPARTMENT 180 DPYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200CederStreet 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•BB70 PROJECT OVER 90 DAYS DURATION. <br />