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� Date 4/2s/93 `� �p,s�,N� �e Zo 9J <br />AVplication For <br />PUBLIC WORKS PERMIT <br />PuoM1CWorbParmlt. "`� `�' ( <br />9iCq OeO� • 40351 <br />Publ¢WorkaFea S <br />Toinl Fec <br />Less Ppol. Feo PaiO s /f(j <br />Ba'�•�ceDuo S '"� l <br />Print or Type Only 1 -' � <br />�� V <br />Select Homes 237 Elm St Everett WA 98203 258-1503 � <br />Ow�er Mailing Address Ciry Zip Phone <br />Oi.ner <br />Applicant biailing Address City �ip Phone , 1 <br />f1 <br />z <br />new house <br />Describe Proposed Work <br />Lot 3 Hanabrook Div 3 <br />Prolect Address (il known) <br />nuaen Inur 141 cooies of plans lor proposed work - Draw to scale and nole the tollowing as applicable: <br />• Property Lines <br />• Outline ar,d dimensions ol all existing and <br />proposed siructures on the lot <br />• Eaisting and proposed utilities <br />• Centerline of sireet <br />• Indicate North <br />• Show any proposed grading changes <br />• Show measurements <br />PERPAIT CONDITIONS <br />1. All calls tor inspection shall be made 24 hrs. in advance - phone 259•8810. <br />2. All work shall be pertormed in eccordance with this permit and current City of Eveiett Desig� and Consiruction <br />Standards and Specifications. <br />3. Call Location Underground Service 4B hrs. before you dig. TOLL FREE NUMBER 1-800�424•5555. <br />Install rock construction entrance t�hind driveNay as per city <br />standard St7.06 and erosion contrnl as directed by Public Works <br />Inspertor. <br />5. Keep city streets clean at + <br />ti. G�rb gutter and aidewalk in <br />any damage thereto shall be <br />Public Works Inapectur. <br />7_ Any change in the driveHay <br />spector, width at prop line <br />8. Connect all roof, yard and <br />11 times <br />the plat art new and undamaged, <br />replaced at the discretinn of the <br />cut must be approved bY the PW In- <br />limited to existing apron Width. <br />drivecaay drains to storm drain <br />syatem provided to lot_ <br />9. Ad,ivat water bozes to grade at end of construction_ <br />10_ Drivewaya ahall br r_ompletely cnred before dciving on them. <br />5= 3 —`i3 <br />�or <br />: �'� <br />Appmved as Constructed <br />�A�IiC/ PUBLIC WORKS DEPARTMENT <br />3200 C�dar Street <br />Everett, WA 98207 <br />Phone: 259�&010 <br />'3 <br />Date <br />ACKNOWLEDGEMENT Of CONDITIONS <br />� <br />W <br />� <br />� <br />N <br />� <br />O <br />� <br />� <br />O <br />a <br />The undersigned ownedapplicant hereby agrees to hold and save harm- <br />less the Cl�y of Everett Irom any ��nd all claims for damages, costs, <br />expenses. or causes ol action that may arise because of inslallalion <br />and maintenance of the improvement or olher righPot�way use hereto <br />applicd lor and lurther agrees to re��ove same upon notice Irom ihe <br />City ntl to replacE aublic properiy damaged ihereby. <br />�c-CL• z. I I�c—,'JZC, <br />t : , , ' t ���y—�� <br />Signatw of AppllcaM Date <br />WORK AUTHORIZED BY THIS PERMIT IAUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSU[D AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BV THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAVS DURATION. <br />