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Date XXXXX 4/23/93 <br />qpplica�ion For <br />PUBLIC WORKS <br />Print or Type Only <br />Sel.ect Homes <br />pwner <br />Describe Proposed'Nork <br />Project Address (if known� <br />TU POSTING ���i�l_q3 � <br />PERMIT <br />237 Elm St Everett WA 98203 <br />Mailing Atldress <br />Mailing Address <br />new house Basic 107 <br />. .,.,n _. .t�w1,. I'L \\/ <br />258-1503 <br />Cit <br />Cit <br />R�/%� � <br />Poo��c Worxs Permn � .�/��- <br />40350� <br />�e , . <br />Puoi,c worxs Fee S <br />Tolal Fee <br />Lesa Aoo� Fce Fe�tl S�� � <br />Baiance Oue <br />( <br />l � <br />�� <br />Phone <br />� <br />Phone L <br />�l'' <br />Lot z nanaoruuK ��• � <br />Attach four (4) copies of plans tor proposed work � Drew to scale and note � Cen1taW�ne of stree� able: <br />• Property Lines • I��dicate Norlh <br />• Outline and dimensions ol all exislin9 antl ��how any proposed grading changes <br />proposed siructures on Ihe �ol � Show measurements <br />• Existing and proposed utilitie: <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hrs. in advance • phone 259•8810. <br />2. All work shall be peAormed in accordence with this permit and current City ot Everett Design and Construction <br />SlAnderds end Specificetions. <br />3. Call Location Underground Service 48 hrs. 6efore you dig. TOLL FREE NUMBER 1•800'424•555 . <br />4. Inatall rock construr_tion entrance behind drivecray as per city <br />atandaz'd f1208 and emaion control as directed by Public Works <br />Inapector. <br />5. Keep city streets clean at all timea <br />8_ �rb gutter and sidertalk in the plat are neN and undamaged, <br />any damage thereto ahall be rep].yced at the discretion of the <br />Public Works Lnspector. <br />7_ p,ny ohange in the drivewaY rut cmast be approved by the PW In- <br />spector, N10th $t proP line limit�d to existing apron uidth. <br />g. Connect all roof, yard and driveway drains to atorm drain <br />system provided to lot. <br />9. Ad,ivat Water boxes to grade at end of construction_ <br />10. Driveaays sha11 }m comPletely cured before drivin� on ihem. <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the Ci�y ot Everett Irom any and all claims for damages, costs. <br />expenses, or causes ol action that may arise because ol inslallation <br />and mainlenance of lhe impro�emenl or othe� right-of�way use hereto <br />applied la and further aqrees to remove same upon nolice Irom the <br />City aJ iA� t9 replac�f�p,u,�b,lic prope�damaged ihereby. <br />ii�-�1��� N'i' i�tt� Mf- <br />,l, � , �L� t �._ S, I Y�- <br />Date <br />Signa�ure o�App�ican� <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREArTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMiT MAY B[ <br />CANCELLED BY THE GTY UPON ANY S'.OPPAGE OF WORK ON iHIS <br />PROJECT OVER 90 DAYS DURATION. <br />for <br />ppproved as Constructed <br />�ArI�� PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett. WA 98201 <br />Phone: 259�8810 <br />S -3 �!� <br />Date <br />��-.�. y� <br />Dale <br />� <br />r <br />� <br />� <br />� <br />� <br />O <br />a <br />