Laserfiche WebLink
� <br />DaM _'�11,1/OC,� <br />� <br />Application For <br />PIJBLIC WORKS PERM17 <br />Print or Type Only <br />M�iling <br />Maling <br />� <br />Describe Proposed Work ��� <br />Project Address (il known) <br />Cily <br />uny <br />vue�¢ wo,Ae ae,��/ ✓ ' ` % <br />Biep. Deo�� � .�/�(� / �� <br />— r7— <br />rubnc worhs Fea <br />Tolel Fea S _ <br />LessAo�� �ce PnIJ S <br />Baia�cc0�e $ �O <br />�I(o�5 " <br />ip Phone <br />iP Fhone <br />LoT/9 cEp.c,e , <br />Attach lour (4) copias ol plans for proposed work - Draw to scale and note ihe following as applicable: <br />• Pioperty Lines • Centerline of slreel <br />• Outline and dimensions of all existing and • Indicale Norih <br />proposed siructures on ihe lol • Show any proposed grading changes <br />• Existing and proposed utilities • Show measurements <br />PFRMIT COIvDITIONS <br />1. All calls for inspection shall be made 24 hrs. in adeance - phone 259•88� 5. <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and Construction <br />Standards and Specificationa <br />;. Cail Localion Underground Service 48 hrs. belore you dig. TOLL FREE NUMBER 1-500•424•5555. <br />4. ANY GRADING DONE ON THIS LOT SHALL 6E DONE SO AS NOT TO IMPACT THE <br />SORRCUNDING LATS WITH RAINWATER RUNOFF. <br />5. ANY CURH & GUTTER OR SIDEWALK DAMAGED DURING CONSmor�CTION SHALL BE <br />REPLACED BY THE APPLICANT. <br />6. ROOFTOP DOWNSPOUTS SNALL BE TIGHT-LINED TO TF.E PUBLIC DRAZNAGE SYSTEy <br />� C-+'� ip?G'e�f'/—� ..J�J �� <br />ApprovcA � r Construction Date <br />� 1 , _ 2 �-:���7 <br />FINAL :NSPECTION Date <br />Approved as Constructed � <br />evrrMt PU�LIC WORKS DEPhR� i!ENT <br />� � 3200 Cedar Street <br />Everett, WA 98207 <br />Phone: 259-8815 <br />W <br />i <br />N <br />� <br />O <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The unde�signed own=r/applicant hereby agrees to hold : nd save harm� <br />less ihe Ciry o� Eveiett Irom any and all claims for dam�ges, cosis. <br />expenses, or causes ol aclion Ihat may arise because of installation <br />and maintenance ol the improvement or olher right-ohway use hereto <br />applictl lor an¢ turther agrees lo remove same upon nolice �rom Ihe <br />Cily and to r�lace pu6lic prope�damaged ihereby. , <br />Signa�urc of Applir,a ' � �ate � <br />WORK AUTHORIZ BY THIS PERMIT MUST E STARTED WITHIN <br />1B0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CIT1' UPON ANY STOPFAGE OF WORK ON THIS <br />PROJECT OVER n0 DAYS DURATION. <br />