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/� <br />Date 3�17/9S • PubLCWork9Parm11� �_.L� - <br />eme o�c� • L7773 <br />qpplica'ion For <br />PUBLIC WaRKS PERMI'� � <br />CL <br />[i <br />(�� p <br />Print or Type Only .�- �OSTI�� �5---?--''.L <br />0 kcrest Home= Tnc 1;712_f"it1LPL <br />Owner N aili � � :�ddress <br />Scott Ptorris _. _ <br />ApplicaM tdailln<• Address <br />Describe Proposed \Nork <br />I.:�� house — Ba:;i= 'L42 <br />Prolect Address (��I known) -------�- ' �=26 <br />oc.� nr., o <br />c,r:i pai b� <br />�:t t'�O J <br />�n [D v] +-+ M <br />.: e� en M <br />Pu�lit W0�k9 Fe0 $ <br />Tolal Fea <br />less AOC�� Fee Paid $ �7 <br />� Bal�Se Du� r� �j /'� I <br />f. T _ <br />O li� O �O d <br />c..i o ... a, r , <br />«a � w r.� c-� <br />M . C'J <br />yY`- c2ip- m c? � Phone <br />.3. r� � n � r. ;� w �_ <br />r, c� u=�� x� o�. n w c� ��� <br />U r'� ul L] f_'� L] r-� i� F- [n 3 u) l.� <br />O�.i .� W._I ip' 4_' O�t O W - 1. <br />a t�� i�,. _. ii] (fl Ll ST. Ct YC Ul u) [� <br />y Zip Phone /,� <br />( <br />� <br />� <br />Attach tour (4) copies c� plans for pn po :�d work - Draw to scale and note the lollowing as apUlicable: <br />„, <br />• Property Lines <br />• OWline and dimens�onr ol all eaisting and <br />proposed structures or �he lot <br />• Exi5ling and p�oposed uiili�ies <br />• Centerhne o s ree <br />• Indiwte Norih <br />• Show any proposed gruding changes <br />• Show measuremenls <br />PERMIT CONDITIONS <br />1. Ail calls for inspection shall be made 24 hrs. in advance • phone 259•8810. <br />2. All work shall be pedormed in accordance with this permit and wrrent City of Everett Design and Construction <br />Slandartls and Speci�ications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800•424•5555. <br />1. ��1;�1� �„�g Cn71ch11ChOR rntra�cc belund drivewa�' as per city st;uidard fi'OS mid �resien conLel as clircctcd l� <br />F•ub[ic \'%�rks L�spector. <br />5. t:c�p cit}' sir�cts dc�n at aIl times. <br />G Cnrb enncr nnd sidewalk in the plut .ue new �nd andnm�,ed. a�rv d,imae.e thereto shall hc replaccd at Uic <br />1I151'ICilUil O�IIIC PIIIIIII' �t�01I:s Lispector. <br />'. Any chsnrc o� thc drivc�eny cut must b� approved b)' ihe P\V lnsp�ctor. width �t prop Wic l'united to existiii�. <br />apron widlti. <br />S. Curb faee etraius m' oilier �louu drau� shib, ha��c becu pi��•id;il to c�ch lot u� the plat fui the conueeUon uf <br />ioofl�p Jotvnspotds. <br />a_ <br />1�: <br />� —__ <br />��y c�_ 3 �' 9s <br />Approved lor JnStr�c��oR — Date <br />/ <br />ll.�: � �'3 -�i � <br />FINAL INSPEGTIOPI Date <br />Appwved as Construcled <br />PUBLIC WORKS DEPARI'MENT <br />�, 32G0 Cedar Street <br />Eve.reV, WA 98201 <br />Phino: 259�8870 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />H <br />� <br />N <br />� <br />O <br />f— <br />� <br />O <br />a <br />The undersigned owner/applicant hereby ac�rees to holA and save hann� <br />less the Gry of Everelt from any and all claims tor dama�jes. costs. <br />erpenses, or causes ol aclion that may arise because of installatien <br />and maintenance of ihe improvement er olher right�ol�way we heielo <br />applied lor and furiher agrees to remove same upon noGce Irom thc <br />Ci�y and to replace public property damaged thereby. <br />r.� ' �--/� -S'� <br />Sig� alure ol Appli nt Date <br />WORK AUTHORI�ED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERAt1T IS ISSUE'J AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COIv1PLETION. THIS PERMIT M�Y BE <br />CANCELLED BV THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJEGT OVER 90 DAYS DURATION. <br />