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/ . <br /> �ate �-23-90 - r�oe�wo�ksva,m��, `�/Za�- <br /> o� Application For eiaA o�ai •_9.0/9d6A8 <br /> �.� <br /> PU�LIC WORKS PERMIT Pu�1�cWorksFee <br /> Totnl Fee $ <br /> � less AoO�.Fce Paid � <br /> O �'�(� <br /> O O PJ O Cl O Q O O CJ Balanca Uuo S <V <br /> Pfint Of TypO Onl� �� � �� � �� � �- `� � �� <br /> L� lnpO"-? ri o o c� ow <br /> �.�. +lfl O. y� ui N Yl I�" .-� �f] N <br /> �17 �M Ni W M Ml 1fl� q! N �+ <br /> �� !A � � Vi <br /> m <br /> Universe Coirst. w 2529 - la�th�E Bothell 98012 481-3366 <br /> Owner � r� Nl'silih¢;Ad�reSs� r.: �i " City Lp Phone <br /> � p`� � r`�a � -� u5 � o � o .-WSo Niii <br /> � b J J �+J J �i O L O la� .-+ 2 <br /> I� 3C 6] O_ 6. �] [� z ' u u G] .-a c� <br /> Owner �� <br /> Applicant Mailing Address City 2iP Phone <br /> Describe Proposed Worh New 'n la Fami� rP idrnra <br /> - - �.� W <br /> Lot i1F - Ridgevrood Terrace (p 229 — Z r+,� D2 5� � <br /> Prolect AAdress(if known) - <br /> Attach Pour�!)copies of plans for proposed work- Draw to scale and no!r. Ihe lollowing as applicable: � <br /> • Property Lines • Centerline ol street � <br /> • Oatline and dimensions of all eaisting and • Indicale North <br /> proposed structures on the lot • E.�c�•� �� proposed�rading changes <br /> • Existing and proposed utilities • Show me..uremenls � <br /> DO NOT WRIT[ BELOW THIS LINE O <br /> PFRMIT CONDITIONS <br /> t.All calls for inspection shall be made 24 hrs.in advance-r!:one 259•8610. � <br /> 2.All work shall be performed in accordance wi�h this permit and curren�City r,l Everett Design and Consiruction <br /> Standards and Specifiwtions. <br /> 3.Cell Location Underground Service�t8 hrs.before you dig.TOLL FREE NJMBER 1•800•424•5555. � <br /> 4.ANY CHANGE IN THfi DRIVfiWAY CUT MUST BE APPROVfiD O <br /> BY THfi PUBLIC WORKS INSPSCTOR_ � <br /> 5.CONNfiCT DOWNSPOUTS TO PUBliIC DRAINE.GH SYSTEM. <br /> 6.KEHP CITY STRfi6TS CLEAN AT ALL TIMSS. � <br /> 7.ANY DAMAGb TO THE CURB AND SIDEWALK WILL BE REPAIRfiD <br /> TO THE SATISFACTION OF THE PUBL�IC WURKS DEPT. O <br /> a <br /> :{CKNOWLEDGEMI_N�i OF CONDITIONS <br /> The undersigned otvner/applicanl he�eby agrees to hold and save he.m- <br /> less ihe City ol Everett Irom any and all claims lor dama�es, costs, <br /> ezPenses, or causes oi aclion ihat may arise because of inslallation <br /> � (� Y,Vq��J � _ �j^9� and maintenance ol !he improve�ient or other righbol�way use hereto <br /> Cb�x-- � apPlied for nd lur er agre to remove same upon notice Irom the <br /> Approved for Constructi n Da�e City and t plac public perty damaged thereby. <br /> ,/V �t�'` /� I — �� . <br /> FINAL INSPECTION Date � (�-�^ <br /> App oved as Constructed ignature ol Applicant � � Date <br /> WORK AUTIIORIZED BY TI11S PERMIT MUST BE STARTED WITHIN <br /> everett PUBLIC WORKS DEPARTMENT 180 DAYS OF DATE P[RMIT IS ISSUED AND THEREAFTER IS TO <br /> � 3200CetlarStreet BE DILIGENTLY PURSUED TO CO�dPLETION.THIS PERMIT MAY BC <br /> Everett,lNA 9�201 CANCELLE�BY THL C�TY UPOK ANY STOPPAGE OF WORK ON �HIS <br /> Phone:259-8810 pROJECT OVER 90 DAYS DURATION. <br />