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Date ��19/93 <br />Application For <br />PUBLIC WORKS <br />Print or Type Only <br />�`'_' p�ST[NG �� ��=5 � <br />P�RIV�T <br />O <br />z v�i�oo`u�n <br />o� '+ .1 O O `� O <br />v� vi r�i r•i «� c., <br />rM N� c~4 M M <br />�ti P <br />John West E216 Henning Dr Stanwood T9�292 775-21 <br />Owner <br />Owner <br />Mailing Adtlress �i o d3il� x i.7 :t =: <br />i oo �xy" <br />fJ S�C CJA fi = O U�l O <br />Applicanl Mailin9 Address Cily <br />New duplex - Basic 223 <br />Describe Proposed Work _ <br />cLot <br />Projacl Address lil known) <br />0 <br />� <br />n <br />u+ <br />Pub�¢ Worhs Pe�mil a� i' 7 <br />Biep oco�� � C4 359 <br />Puolic Worxs Fec <br />Ta�al Fec S <br />Le55APpl FeePai� 5 � <br />� O <br />��1 nce Ouc S <br />Zip Phone <br />Atlach lour (4) copies ol plans lor proposed work � Draw to scale and note Ihe lollowing as applicable: <br />• Property Lines <br />• Outline and dimensions of all existing and <br />proposed structures on the lot <br />• Existing and proposed utilities <br />Y� <br />• CenteNine ol streel <br />• Indicale Nnrih <br />• Show any proposed grading changes <br />• Show measurements <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 pedormed in accordance wilh ihis permit and curreM City of Everetl Design and Cons�ructlon <br />Standards and Specifications. <br />3CalI Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800•424•5555. <br />4. lnste:ll rock construction entrance behind driveNay as per city <br />standard N208 and eroaion control as directed by Public Worka <br />Inspector. <br />5. Keep city streets clean at all times <br />6. G�arb gutter and sideWalk in the plat are neW and undamaged, <br />anY damage thereto aha7.1 be replaced at the discretion of the <br />Publir. Works Inapector. <br />7. My change in the driveWay cut must be approved by the PW In- <br />spector, taidth at prop line limited to existing aprnn width_ <br />8. Connect all roof, yard and driveWay draina to storm drain <br />system provided to lot. <br />9. Ad,iust water boxes to grade at end of conatruction. <br />10. IJriveways shall be r_ompletely cured before driving on them. <br />as Constructed <br />�PUBLIC�VORKSDEPARTMENT <br />3200 Cedar Sireet <br />Everelt, WA 98201 <br />Phone:259-8870 <br />ACKNOWLEDGEME�JT OF CONDITIONS <br />W <br />� <br />� <br />N <br />� <br />O <br />� <br />N <br />O <br />a <br />The undersigned owner/applicant hereby agrees to hold and savc harm- <br />less ihe Gty ol Everet� Irom any and all cleims for damages, costs. <br />expenses. or causes of aclion that may arise because cf installation <br />antl maintenance ol lhe improvement or other right-o��way use herelo <br />�nn��ed io� and further agrees to remove same upon notice irom ;he <br />City and to replace public property damaged thereby. <br />� / � c���✓ <br />gn ure ol Ap�nlicant ���' <br />O�K AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />1B0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DIIIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAVS DURATION. <br />