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Date 5-'16-93 TO P�►ST(NG ___���.2� C%� - 1-2�-� <br />Application For <br />PUBLfC WORKS PERMIT <br />Print or Type Only <br />PuCllc Wo�ks Fermit � _ <br />c �, / <br />BIJO� Deo�. • 40724 <br />PublicWodaFae S <br />Total Fee <br />Leas ApaL Fae Peitl s T/'— <br />s �N <br />BalanceDue � _ <br />Select Homes 237 Elm St Everett WA 98203 258-1503 <br />C� <br />Owner Mailing Address City Zip Phone <br />Owner tJ <br />Applicant Mailing Address City Zip phone < <br />Describe Proposed Work new house � <br />Proiect Address (if known� 5924 4th Dr W Lot <br />Atlach four (4) copies of plans for proposed work • Draw to scale and note the tollowing as applicat'=: <br />• Property Lines <br />• Outline and dimensions of all ezisting and <br />proposed structures on the lot <br />• Existing and proposed utilities <br />• Centerline of sireet <br />• Indicate Norih <br />• Show any proposed grading changes <br />• Show measurements <br />PERMIT CONDITIONS <br />t. All cells for inspection shall be made 24 hrs. in advance - phone 259•8810. <br />2. All work shail be pedormed in eccordance with this permit and current City of Everett Design and Conatruction <br />Standerds end Specifications. <br />3. Call Locetion Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424•5555. <br />[nrstall rock construction entrance behind driveway as per city <br />atandard it208 and eroaion control as directed by Public Works <br />Inepector. <br />Keep city atreets clean at <br />(�rb gutter and aidetralk i <br />any demage thereto ahall. <br />Public Works Inspector. <br />Any change in the driveWay <br />apector. Width at prop lin <br />Connect all roof, yard and <br />syetem provi.ded to lot. <br />all times <br />n the plat <br />be replaced <br />cut muat <br />e limited <br />driveway <br />are nes� and undamaged, <br />at the diacretion of the <br />be approved by the PW In- <br />to existing apron width. <br />drains to atorm drain <br />9. Ad,ivat crater boxea to grade at end of construction. <br />].0. Driveways ahall be completely cured before driving on them. <br />Approvedfor <br />FINALINSPE <br />Approved as 1 <br />�� <br />L <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Slreel <br />Everelt. WA 98201 <br />Phone: 259�8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />H <br />� <br />Z <br />O <br />� <br />� <br />O <br />a <br />The ur.dersigned owner/applicant hereby agrees to hold Tnd save harm- <br />less �he Cily o� Everett irom a�ry and all daims lor damages, costs, <br />expenses, or causes of action ;hat may arise hecause of instellation <br />and maintenance of the improvement or other riohFol-way use hereto <br />applied tor and lur�her agrees to remove same upon notice trom �he <br />City and to mplace public properry damaged thereby. <br />Signature ol� V�� Date <br />WORK AUTHORIZEO BY THIS PERMIT MUST BE STAfiTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANV STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />