Laserfiche WebLink
Dal�. ��' <br />Applicalion For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />PUUbc Wo�ks Parmil • �_ /�� <br />omp. oao�� • 6��� <br />Pu�hcWo�ksree s <br />imnlPao <br />LnseApol FeoPeiE S � <br />n <br />oaiance ouo $ 2O � <br />Applican� <br />Dascrihe PioPoeed Work <br />Prolect Address lif known) <br />AAdress <br />� �/ <br />��� <br />Attach lour (4) copies ol plans lor proposed work • Draw to scale and note �he following as applicable: <br />• Property Lines • Cenlerline ol street <br />• Outline and dimensions o� all exis�ing and • Intlica�e North <br />proposed structures on Ihe lol • Show any proposed qradin� changes <br />• Existing and proposed utililies • Sha.•� measuremenis <br />Phone <br />PERA7IT CONDITIONS <br />1. All calls br inspeclion shall be made 24 hrs. in advance � phone 259•881 .ri. <br />2. All work shall be performed in accordance with this pe�mit and cunent City ot Everelt Design anA Consiruction <br />StandarAs and Specilications. <br />3. Call Loca�ion Underground Service 48 hrs. belore you dig. TOLL FREE NUMBER 1•800•424•5555. <br />4. ANY GRADING DONE ON TI'.]:S LOT SHALL BE DONE SO AS NOT TO IMPACT THE <br />SURRUUNDING IATS WITH RAINWA"'ER RUNOFF. <br />5. ANY CURB & GOTTER OF. .iiDEWALK DAMAC�D DURING CONSTRUCTION SHALL BE <br />REPLACED BY THE APPLTGAIVT. <br />6. DOWNSPOUTS FROM THE HOUSE ARE TO BE TIGHT—LINED TO THE DRAINAGE SYSTEM. <br />7.A�Y ORGANIC MATERIAL ON SITE TO BE 6URNED OR HAULEii OFF WITH PERMITS <br />evemtt PUBLIC WORKS DEPARTMENT <br />� 3200 Cedar Street <br />Everett, VJA 98201 <br />Phone:259�8815 <br />�.fJJ� <br />W <br />H <br />�w <br />_ r <br />� <br />� <br />� <br />N <br />O <br />a <br />ACKN DGtMENT OF CONDITIONS <br />Thr� undersig�.ied o�+� • �plican: hereby agrees to hold and save harm- <br />I,�ss ihe City ol Ev �� Irom any and all claims lor Jamages, cosis, <br />axpenses, er r.ause� ..I adion ihat may 2rise because of installalion <br />and maiNenance of Ihe improvement or other right�of-way use hereto <br />applied for and lurther a9rees lo remove same upon nolice Irom 'he <br />City and to replace public property damaged thereby. <br />�_ <br />�„ ,� Cl t/l� d���--- <br />S �ure ol App il ant �`'�` <br />��RK AUTHORIZE� BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREA�TER IS TO <br />BE �ILIGENTLY PURSUED TO COMPIETION. THIS PERMIT MAY BE <br />CANCELLFD BY THE GTY UPON ANY STOPPAGE CF WOFiK ON THIS <br />PROJEGT UVER 90 DAYS UURATION. <br />