Laserfiche WebLink
� <br /> � <br /> Dete z�1��94 +?. a�m��wo�x.rum�n. 9 <br /> Application For � �-L 9_�j..� eiao.o:.;�.. <br /> 4's» <br /> PUBLIC WORKS���MIT <br /> Puelic Worka Fea <br /> g Totel Fee s <br /> V LlSf 40Y�-F!!PdiC s <br /> Print or Type Only g g g g g � g a g Q o��eDue s Zv" <br /> � � � o.po � p(� �� � � o � 0 <br /> �gMMM M M -.a N � �S �/.� <br /> L 5 L Suilders 10711 Evergreen�7y 48204 290-1 � � « <br /> Owner Mai4ing Atldress\ � Cpp � � i� � Phone <br /> i �i <br /> Larry Pond � � � � � � mS � � � 7� � �,' <br /> r� � $ <br /> Applicant Mailing Address Cily Zip Phone <br /> Describe Proposed work New house - Basic 250 <br /> W <br /> Projed Address�if known� �3"�� "' �-"�� �r s� Lot 3 Brookwood Pl � <br /> Attach four(4)copies of plans for proposed work• Draw to scale and note the following as applicabie: � <br /> • Property Lines • Centerline of street � <br /> • Outline and dimensions of all existing and • Indicate Norih <br /> proposed structures on the lot • Show any proposed grading changes <br /> � Existing and proposed utilities • Show measurements � <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1.All calls for inspectbn shall be mede 24 hrs.in edvance•phone 259�8810. � <br /> 2.All work shell be performed in accordflnce with this permit end curteM City of Everetl Design and Construction <br /> Stenderds and Specilicatlons. <br /> 3.Cell Location Undetground Service 48 hra before you dig.TOLL FREE NUMBER 1•800�424•5555. � <br /> 4. Mctal rock condruction eMrance behind d�ive�wy as per city O <br /> standard 1�208 and arosion coMrol as dirocted by Pubic Works <br /> In�Mor. <br /> S.Ke�p cily s1roMa ck�n ri al times � <br /> 6. Cutb putbr and �IdewaYc in the pl�t aro new and undamaped, � <br /> ury dsmaga tMn10 shal bs ropaced at ths diccrotion of the <br /> PuElc Works Inspector. O <br /> i.Nry chanpe la ths drivew�y cut must be approved by the PW In- <br /> cpector,width at prop ine imfled fo existinp apron width. � <br /> 8.Connect al roof,yard and driveway dnins to stotm drain <br /> system provided lo bt. <br /> p.AdJust vater boxes to grade at end o(construction. , <br /> � 10. D�ve�wy� shal be compbley cured before driviny on them. <br /> � ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agreas to hold and save harm• <br /> less the City of Everett irom any and all claims for damages, cosis. <br /> /� ezpenses, or causes of ac�ion �hat may arise because ol instaliation <br /> YI�L l/' _ J���¢ and maintenance ol the improvemen or olher right•ol-way use hereto <br /> �..�C/ G applied for a further agrees :o remove same upon notice from the <br /> Approved for ConS�ruction Date City antl t ep ce publiaP operry da §ed thereby. <br /> ��y� <br /> �--- G -i�- v� � � �� <br /> FINAL INSPECTION Date ' <br /> Approved as Constructed �Signature ol �plicant Date <br /> � PUBLIC WORKS DEPARTMENT WORK AU ORI2ED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200CederStreet 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett.WA9B201 BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Phone:259-8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />