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� <br />TYPE OR PRINT ONLY <br />Application For <br />PUBLIC WORKS PE�MIT <br />PU6LIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Evereil, WA 98201 259-8810 <br />TO POSTING � I e a�► <br />Date �/Z/96 <br />Public Works Permit k —1 �y��_ <br />Building Permit k <br />Public Works Fee 5 <br />� <br />FAIRMONT HOPIES 21902 38TH AVE Id BRIER 98036 356-2435 _ <br />Owner Mailing Address City Zip Phone <br />Applicant <br />Describe Proposed Work <br />PROJECT ADDRESS (if known) <br />Mailing Adtlress <br />NEW HOUSE BASIC 11 <br />03/13/96 1Q':?G,", O�ORkt?^_t <br />H�0052i80 <br />�'O.DO <br />Attach four (4) copies ol plans for pmposed work - Draw to scale and note the following if applicable: 5�`C�'Fu :4.50 <br />•Property Lines •Outline and dimensions of all existing and proposed stmctures on the lot •Enisting and pr��d��Ltilitie�20� QD <br />•Centedine of street •Indicate North •Show any proposed gratling changes •Show measurements b00�0905� <br />DO NOT WRITE BELOW THIS LINE ItpCO3Q748 <br />PERMITCONDITIONS: SEWER 2'?O.DO <br />1. AII calls for inspection shall be made 24 hours in advance - phone 259-8810. 4N��}; y;!,�i;, 7Q <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and <br />Construction Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-ei00-424-5555. <br />d. Ti¢ltl line roofiop nmott'to ch•:�in:tge ca�rse sd refu• oClot. <br />5. Pnve dri�-eway fi om property lin� to edRe of p.rvement in ri,qlri-ot=wny (clriveway width in public <br />ri�Jil-of-way m�y be limit�d to 12' lo reduce nmoll). <br />G. Developer is msponsible for confrolling site nmofl�from �.3rd �1ve., Ihis �aill inc6idc, hut ix nol <br />liiaifed to, inGtalliuc a new i'I3 p� r�land.vd u402 .u�d couslnrctiqc au outlall to th� d„�in:iRo cow s�• <br />thc Ra�-cnna SL R.U.W. � <br />Approved as Consiructed <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned ownedapplicant hereby agrees to hold and save harmless <br />the Ciry of Everett from any and all daims for damages, costs, ezpenses, or <br />causes ot action that may arise because ol installation and mainLnance of <br />the improvement or other right-oFway use hereto applied for and futlher agrees <br />b remove same upon notice fmm ihe City and to mplace public property <br />damaged thereby. <br />WCP,K AUTHORIZED BY THIS PERM1^IT NUST 8E STARTED WITHIN 180 DAYS OF DATE PERMIT� ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO <br />COM1�PLETION. THIS P[RMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THI:� PROJECT OVER 90 DAYS DURATION. <br />