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Date 6/7/93 <br />�C - I - "LP�-4 <br />Application Fcr <br />PUBLIC WORKS P.�F��.'�G� ��,y�3 <br />Print or Type Only <br />Select HonE <br />Owner <br />SHme <br />AppliGant <br />Describe Proposed Wurk . <br />Proiec� Address (il known) <br />Mailing Address <br />Alailing Address <br />New house - Basic 201 <br />t�' <br />Zip <br />Attach four 14) copies ol plans tor proposod work • Oraw to scale and note ihe following as applicable: <br />• Properry Lines <br />• Ou�line and dimensions ol all existing and <br />proposetl structures on the lot <br />• Existing and proposed utilities <br />� �/ <br />PybliC IYO�F) VCffl�i� a <br />� <br />eiao oeo� • 40856 <br />PUGi¢WoiksFee s <br />Toiai Fee <br />Le55 ApP� Fee PeiO i <br />7 /�` <br />Bd�Tl1CC OUP S �c� <br />• Centedine ol sireet <br />• Indicate Norih <br />• Show any �roposed grading changes <br />• Show me�!surements <br />Phone <br />Phone <br />PERMIT CONDITIONS <br />1. All cails for inspection shall be made 24 hrs. in advAnce - phone 259•8810. <br />2. All work shall be performed in accordanc� with this permit and current City of Everett Design and Construction <br />S;anderds end Specifications. <br />3. Call Location Underground Service 40 hrs. before you dig. TOLL FREE NUMBER 1-800•424•5555. <br />4. Inatall rork conatruction entrance behind driveway as per city <br />standard #208 and erosion control as directed by Public Works <br />Inapector. <br />5. Keep city atreets clean at all timea <br />6. Qirb gutter and sidewalk in the plat are neW and undamaged. <br />any damage thereto ahall be replacEl at the discretion of the <br />Public Works Inepector. <br />7. Any chanqe in the driveway cut must be approved by the PW In- <br />apector. width at prop line limited to existing apro^ eidth. <br />8. Connect all roof, yard and driveWay drains to atorm drain <br />syatem provided tn lot. <br />9. A3,iuet water boxes to grude at end of conatruction. <br />10. Drivewaya ahall be completely cured before driving on them. <br />l� <br />�cli-E.fl'l�l<Ce cl��u.�. /���3 <br />Appreved tor Construc+icn Date <br />��� .�-,� -s3 <br />FINAL INSPECTION Date <br />Approved as Constiucted <br />/Ar��PUBLIC WORKS DFPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />Phone:259�8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />� <br />L <br />� <br />�a <br />W <br />H <br />� <br />� <br />� <br />O <br />a <br />The undersigned owneVapplicant hereby agrees to hold antl save harm- <br />less the Clty ol Everett Irom any anA all claims lor damages, cosis. <br />exper.ses, or causes of actlon that may arise because ol �nstallation <br />and maintenance ol ihe improvement or other righPohway use hereto <br />applied lor and lur;her agrees lo remove same upon notice Irom the <br />City anC to replace pubGc property damaped ihereby. <br />�z�..�� �-q��-� <br />Signature of Applicant Oate <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STAR7ED 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 ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />