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� � � <br />C�H <br />9HN <br />1 <br />K � n <br />H 7G <br />oxo <br />^UH�1 <br />5HNt' <br />h70� <br />OH <br />��g <br />�j]Y �] <br />�H� <br />CNH <br />O H <br />CC�C� <br />[sf � M <br />zo� <br />� <br />l-a - '`1" `���- <br />4-15-93 `l� a,�ei�cwo��are�mn. �J � <br />Date o„� oep, , 40250 <br />Application Por <br />PUBLIC WORKS PERMIT °°"';�,a����`°` 5 <br />TO !'OSTING _ �/_!_/_93 "„"�°"`�°.,�° 5 <br />�— <br />Oa6+nm ouo $ .G-(� <br />Print or Type Only <br />Select 1lomes 237 F.lm St Everett WA 98203C'YZ58-1503 ZIp phone <br />Ownei Mailing Atldress <br />Owner <br />Descri6e ProposeJ Wa�k <br />se <br />Address <br />Proled Address hf knowN �� �� � :3Yd ��� -- <br />A��ach lour I�) CoP�eS 01 Plans b� Propo56d work - Draw Io SCnle and noie me lollmving as applica6le�. <br />• Propeny Lmes • G nterline ol street <br />• OWline and dimensio�s ol all existin9 antl • Indicate Noith <br />pmposed structures on �he lol • Show any proposeA 9�a�A��9 ch�nqe; <br />• Existing and proposed utihties • S�row measuremenls <br />PERMIT CONDITIONS <br />1. All calls b� inspection shall Ce made 24 hrs. in advance � phone 259•8810. <br />'� � 2 NI work shall be pedormed in accorduce W�lh ihi5 oermit and curreN Ciry ol Everelt Desi9n and Consiruction <br />_ _1 Standards and Specilicatit � ; <br />3. Call Location Undergrouod Service �18 hrs. belam you dig. TOLL FREE NUMBER 1•800•424•5555. <br />9. Install ror_k <br />standard tl70 <br />Insper_tor. <br />cunstruction entr.�nre behind driveeay as pr.r cit>' <br />A and erosinn rontrol as directed by Public Works <br />5. KeeP city atreetn r_lean at <br />d. Curb ��t•ter and sidewalk i <br />any dama�e thereto shall be <br />{��bli.r Works InsFertor. <br />7. Any chanee in the drivec+ay <br />apector. Nidth at Frop linr <br />d, Connect all roof, yard and <br />'riad t�i 7ot <br />a11 times <br />n the plat are neN and undama�ed, <br />rr.F'lared at the dierretien of the <br />cut must be aFProved }rv the F4! In- <br />a li.mited to existin@ rpron width. <br />driveWay drains to storm drain <br />system provt - <br />9. Ad,iust Nater lx�x's tu �rade at end of construr_tion. <br />10_ Driveuays shall be rnmFletely rured Ixa£ore drivin� un t.hem. <br />� i����� q/�/�3 <br />� <br />Approved lor Consiructio� Daie <br />�� /' <br />�.� �' �, i -; -- � rs -i� <br />FIN�L INSPECTION Datc <br />Approved as Constructed <br />" PUBLIC WORKS D[PARTMENT <br />��3200CedarStreet <br />�,� [veretl.WA9B201 <br />Phonc:259�00�� <br />ACKNOVJLEDG[AtENT OF CONDITIONS <br />�� <br />�J <br />� <br />O <br />ihe unde�signed owner/applicant hereby agrees to hold and save h, rnr <br />less Ihe Gq� ot Everell Irom any antl all claims for damages, costs. <br />expenses. or causes of ac�ien ihat may arise because o� installalion <br />and mainlenance of lhn improvement or other nghPobway use heret.� <br />applieA �or and furiher a�rees lo remove same upon noti[c Irom tne <br />City i�d to reP�ace ubhc properp��•�/1,a�maged Ihereby. <br />��W,'C/ T Vi/LCi <br />��� . ��ZCG ' �—`� <br />Signat�e o� APPhcant / �' <br />WORK AUTHORIZE� 6" THIS PERMIT MUST BE STARTED l. � N <br />100 DAYS OF DATE PERh11T IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTL� PURSUED 70 COMPLETION. THIS PERMIT IdAY BE <br />CANCELLED BY THE CITY UPON ANV STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 D�YS DURATION. <br />