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2/17/94 .1 p�plicWorMSPermiu `� a� _J <br /> Date • TO POtfING ��°/�L _.em, o�o� . 43551 <br /> App�jy�atinn For <br /> PUBLIC W(�RKS P�RMIT PueTa�FeaFea s <br /> �p Less Roo�.Fee Paid S A^ <br /> p 0 ^ � Balanca Oue S 4S/ <br /> Print or Type Only s `vi� 0 4'u i i � �3 o f� <br /> ��n, ONOO .Y O O O OCJ ��-' <br /> Ifl � N M V � M .+ M �O VI . <br /> N M � <br /> L & L Builders 10711 E�rgreen Wy 9�204 29d'-1818 <br /> Owner \8ili AdJress � y p � i1�n � Zip Phone <br /> ,p StO cr 3 O � O � �-+ t� <br /> p O � � U O U� :T p F L� W <br /> Larry Pond � a �id � oim � = � � � = � <br /> Applicant Mailing Address City Zip Phona <br /> New house — Basic 249 <br /> Describe Proposed Work <br /> W <br /> 74p�{- — 2,nd D� 5E Lot 1 Brookwood Pl � <br /> Prolect Address(il known) � <br /> Aftach four(4)coV�es ol plans for propOsed work•D�aw to scale and nute the following 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 changes � <br /> • Ezisting and proposed utilities • Show measurements M <br /> W <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> , 7.All calls for inspectbn shall be mede 24 hra.in advence•phone 259�8810. � <br /> 2.All work ahall be peAormed In eccordence with thls permit end curcent City of Everetl Design and Construction <br /> Standerda and Speciflcetions <br /> 3.Cell Locatlon Underground Service 48 hrs.balore you dig.TOLL FREE NUMBER 1•800-424•5555. � <br /> 4. Inda1 rock consttuctfon etHronce behind drive►wy ac per eHy O <br /> :tandaM A►208 and aroslon comrol as directad by Pubic Wo►ks <br /> k�spector. � <br /> 5.K��p clry stroets ckae ri al times <br /> 8. Curb putler and side►wk in the pW are new and und�maged, � <br /> �rry damags thertto shsl be ropbced al the dlscrotion o(the <br /> Pubic Works Inspector. O <br /> 7.Nry changt In ihe driveYwy cul muct be approved by the PW In- <br /> spector,width ri prop ine fmlled to existinp apron width. /� <br /> 8.Conn�ct al root,yard aod d�vay drains to dortn dnin Iri <br /> system provided to bt. <br /> 9.AdJus1 water boYes to Qrade at end oi censln:cffon. <br /> f 10. Drive►wys shal be compktey curod before driving on them. <br /> ^��q ACKNOWLEDGEMENT OF CONDITIONS <br /> ' 11�`� The undersigr.ed owner/applicant hereby agrees to hold and save harm• <br /> v less Ihe City of Everett from any and 211 claims for damages, costs, <br /> ezpenses. or causes ol action that may arise because ot installation <br /> /1,fC`�/�/�� 7 and maiNenance ot the improvemenl or other righFof-way use hereto <br /> /�� /�CD� I _�� _�� applied for and furiher agrees to remove same upon notice Irom ihe <br /> Approved for Construction Date City an epl�ca P � pro damaged thereby. <br /> ��— �''z S.'9 y , <br /> FINAL INSPECTION Date Date <br /> Approved as Conslmcted Signat ol Applicent � <br /> � WOR AUTHORI2FD BY THIS PERMIT MUST BE STARTED WITHIN <br /> � PUBLICWORKSDEPARTMENT 180 DAYS OF DATE PE9MIT IS ISSUED AND THEREAFTER IS TO <br /> 3200CedarSireot BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Everett,WA 98201 CANCELLED Bl'THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259�8870 PROJECT OVER 90 DA"S DURNT'ON. <br />