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j <br /> Date 6�ZS�9O pubi¢WoiksPermn• ��Z� <br /> ;_� Application For eie9 oen�.• 90�24914 <br /> PUl�LIC WORKS PERMIT P�����,��,�_�� — <br /> C� Tola'fee S <br /> � Less Rnol.Fce Paie S <br /> O <br /> O O O p O O O G O O <br /> Prlflt OrTypB Onlyi �' � o m ��o c; o a o v; e.,ir�:�o�� S 2D� <br /> w ,ai t�� o �o t o 0 0 o r? �� <br /> r�! ra ,u o� � .n oi �a r� ,-� .-+ �� <br /> � v w �g e� oi W as �i pl (1� <br /> Y ui ur .y <br /> � CJ ++� <br /> North Crest me.,v. Wr�M 162�2 B�othd,l.1 4�y SE #F129 Mill Creek 98012 338-1985 <br /> Owner � ��� �.4a�li�gAdtl7ess�-�=-n fr. r;i r< p{� .� ZiP Phone <br /> r� o � ��o w a �.i u <br /> .. o r� r� r.� " u>>c• �— o -n o r w <br /> \ O J J 4J J u'_O d p liJ ._ .-� 2 <br /> O] S u] i)_ r �t C]C]a 3 �rt UJ iii M �� <br /> OwItPT � �� <br /> Applicant Mailing Address City Zip Phune f <br /> 5 , <br /> Describe Proposed Work New Sinale family residence �-.O� � Z i � <br /> W <br /> Project Address(ii known) bTO� — 7nd nr SF. � <br /> Attach four(4�copies of plans tor proposed v,nrk� Draw to scale and note Ihe lollowing as applicable: „� � <br /> • Property Lines • Centerline ol sireet � <br /> • Outline and dimensions of all ezisting antl • Indicate North <br /> proposed structures on the lot • Show any proposed�rading chanc�es <br /> • Existing anA proposed utilities • Show measurements � <br /> DO NOT WRITE BELOW THIS LINF. <br /> PERMIT CONDITIONS O <br /> 1.�\II calls for inspection shall be made 2a hrs.in advance•phone 259-8810. � <br /> 2.All work shall 6e performed in accordance with this permil and current Ciry of Everetl Design and Construction <br /> Slanderds and Specilications. <br /> 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1-$00•424•5555. � <br /> 9 .ANY CHANGE IN THE DRIVEWAY CUT MUST BE APPROVED O <br /> BY THH PUHLIC WORKS INSPECTOR. <br /> 5.CANNSCT IX�WNSPOUTS TO PUBLIC DRAINAGE SYSTEM. � <br /> 6.KEfiP CITY STREETS CLEAN AT ALL TIMES. <br /> 7.ANY DAMAGE TO THE CURB AND SIDEWALK WILL BE REPAIRED �/� <br /> TO THE SATISFACTIGN OF THE PUALIC WORKS DEPT. ��� <br /> Op� <br /> li <br /> �II! ACKNOWLEDGEMENT pF GONDITIONS <br /> V The undersi�ned owner/applicant hereby agrees to holtl and save harm- <br /> � less ihe Cily ol Everett Imm any and all claims fer A;�mages, cosls, <br /> expenses, or causes ol acticn ihat may aiise because of installation <br /> � ��MC��� �_Z9 _C�� and mainlenance ol ihe improvement or other righFobw3y use hereto <br /> applied for and luriher ayrees to remove same upon no�ice from Ihe <br /> Approved for Cun�ruction . Date City and lo replace puhL� property damaged thereby. <br /> .�`��-- �� -a r- 9� (�j <br /> FINAL INSPECTION Dale �f�t�.-. �X , �� �f�3�q� <br /> Approv d as Constructed Signa;ure ol App6cant ate <br /> everett PUBLIC WORKS D[PARTMENT WnRK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> � 3200CedarStreet 780 DAYS UF DATE NERMIT I� ISSUED AMD THEREAFTER IS TO <br /> Everett,WA 98201 BE DILIGENTLV PURSUED TO CJMPLETION. THIS PERMIT MAY B[ <br /> Phone:259•8810 CANCELLED �Y THE CITY UPON ANY STOPPAGE OF IVORf(ON THIS <br /> PROJECT OVER 90 DAYS DUR�TION. <br />