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� --- --- ------- <br /> , „ ---- ----- --- -- --- -------- --� <br /> Date 1-4-94 • �O POST�i\G " �z� "/ � �i OIU <br /> Puplic Work�Permit• <br /> Application For , eiao.oao�.• 43142 <br /> PUBLIC WORKS �ERMIT Pvbl¢WOA�FN <br /> � Tot�l Fee f <br /> - `�' � �su�00�Fae P�iC s r� <br /> � , �nce oua s `U _ <br /> Print or Type Only - _ � �; �; $ � � � g � <br /> � o, ri c i .� c� y2 vi ci o� .� (l . <br /> In �] R .�+ M r�l o [� C- ri � <br /> O. M � � , � r-�� M � .� � <br /> Select Homee 23J Llm St Evere�t WA 9H2O3 °2.48��5�� "` <br /> Owner Mai4ing Addr �s� r? �Gity � q � � Zi � <br /> � aor �, r., c�_ ���''i�� r� P� ., Phone <br /> �i bn � ili �+ ci� � p F- OF. � laJ M �L.'r <br /> Owner ,.�., � re �' r �1' m �.` $ � a � ' � � t� � <br /> � �pplicant Mailing Address City 2ip Phone ' _. - ,� <br /> �., <br /> Dascribe P�dppsed Work naw houee ' �• <br /> . � <br /> _� _ <br /> ��4A. <br /> ProjectAddress(ifknown) 5710 let Dr W � r Lut 5 Hanabrook 4 � <br /> Attech four(4)copies of plans for proposed work• Draw to scale and note the follow ng as applicable: � <br /> • Property Lines � • Centerline of street , � <br /> • Outline and dimensions of all existing and , • Indicate North <br /> proposed slructures on the lot . • Show any proposed grading chenges <br /> • Existing and proposed utilities � � Show measuraments � <br /> . DO NOT WRITE BELOW TMIS LINE <br /> PERMIT CONDITIONS O <br /> 1.All calis for Innpectbn ahall be mede 24 hrs.ir advance-phone 259�8810. � <br /> 2.All work ahall be peAormed in accordance with this permit and curtent City of Everett Deeign end Conetructlon <br /> StendeMs end Speclflcationa . <br /> 3.Cell Location Underqround Service 48 hra before you dig.TOLL FREE NUMBER 1•800-4245555. � <br /> 4. Ind�l rock construction entrance bshlnd driveway as per c(ly O <br /> startd�rd*208 +�nd emslon corrtrol as direcled by Pubtc Worls <br /> Inspector. <br /> 5 K�ep cMy strosts cwan at al tim�s � <br /> 6. Curb p�ttar md sfdetwk fn the plat am nnv�nd undamagad, - <br /> arry damag�thereto shal be replac�d at the dier.reHon of tha � <br /> PubYc Wor{cs Inspector. , <br /> 1.Aey chengs in ihe drivebvay cut must be approved hy the PW In- ' . ;: O <br /> cpector,vidth�t prop Wne �mUed to erioUng apran wi�th. n' � ' <br /> B. Connecl at root,yar�,and driveway drafnc Ia storm drnin /� <br /> cy�stem proo�dad to �.t: , � li� <br /> 8 Ad)un«'aler baxes to grade at end o(construction. � <br /> 10. Drive�sya shap be compkley cursd beforc d�iving �n them. <br /> ACKNOWLEDGEMENT GF CONDITIONS <br /> ���� The undersigned owner/applicant hereby agrees to hold and save harm- <br /> less the Cily ot Everett from any and all claims tor damages, wsts, <br /> ezpenses, or causes of action Ihat may ariae because of installation <br /> ��� �-'��,r� ,� I _ -� _ c�d_ antl maintenance ot the improvement or other rlghPohway use hereto <br /> � � applied foi and further agrees to remove aame upon notice from the <br /> Approved for Construction Date City and to replace public property demaged there . <br /> � <br /> c��' .. /_ � . <br /> _ .� �i. ,y � 1 ���/ <br /> FINAL INSPECTION Date ( <br /> Approved as Constructed Signature ol Applicant ate <br /> � PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200CetlarStreet 780 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett WA 98201 BE DILIGENTLY PuRSUEO TO COMPLETION.THIS PERMIT MAY BE <br /> Phone:258•8810 CANCELLED BY ifiE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER�90 DAYS DURATION. I <br /> � <br />