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7/19/93 xr, �'OSTING�-��Cb'-s� <br />Date <br />Application For <br />PUBLIC WORKS P'ERMIT <br />Print or Type Only <br />Sohn West 821E Henatng Dr Stanwood 98292 <br />Owner <br />Owner <br />Mailing Address <br />C1�Y <br />n-, <br />rn <br />Q <br />O <br />O <br />Cl <br />7 O O <br />]� �: f,l f� <br />r :. .-� .a� o <br />o in tn ra <br />c�i �ww <br />. o <br />7��2i30 or <br />6.�—O C] CO 3[ <br />�� (J �J J l�J <br />�:� �mia s' <br />PuOLc Wo�b Permil • � <br />eiac. oeo� . C4136 <br />�h� WerFs Fec <br />Tolal Fea S _ <br />s AO�I Fce Pai� � <br />O C� O O T%.-� <br />3Z• o�P o cr 1�ri <br />ir: <br />n <br />Applicant Mailinc� Address City Zip Phone <br />Describe Proposed Work New duplex — basic 223 <br />Proiect Address (if known) <br />Attach four 141 copies of plan� lor proposed work - Draw lo scale and note the following as applicable: <br />• Property Line <br />• Outline and a. ��isions ot ail existing and <br />proposed strucwres on the lot <br />• Existing and proposed utilities <br />• Centerline ol sireet <br />• Indicale Norih <br />• Show any proposed grading changes <br />• Show measurements <br />PERMIT COND1I�IONS <br />t. All calls lor inspection shall be made 24 hrs. in advance • phone 259•8810. <br />2. All work shall be performed in acwrdance with ihis permit and curtent City ol Evered Design and Consiruction <br />Standards and Specilications. <br />3. Call Location Underground Service 58 hrs. before you dig. TOLL FREE NUMBER 1•800-424•5555. <br />4. Install ror_k constructi.on entrance behind driveWay as per city <br />standard #208 and erosion control as directed by Public Works <br />Inspector_ <br />5. Keep city streets clean at all times <br />fi. (,lzrb gutter and sidewalk in the plat are new and undamaged, <br />any damage thereto ahall be replaced at the diacretion of the <br />Public Works Inspector. <br />7. Any change in the driveWay cut muat be approved by the PW In- <br />spector. Width at Frop Line limited to existing apron Nidth. <br />8. Connect all roof, yard and drivewaY draina to storm drain <br />sYatem provi.ded to lot. <br />9. Adjust crater boxea to �rade at end of conatruction. <br />10. Driveways ahall be completely cured before driving on them. <br />��Y�� 7 � 13 <br />Approve for Consir c-on ale <br />��- ��� � - I = �'/- <br />FINAL INSPECTION Datc <br />Approved as Cunsiructed , <br />���y',� PUBLICWORKSDEPARTMENT <br />� 3200 Cedar Slreet <br />� EvereU, WA 98201 <br />Phone:259�0810 <br />ACKNOWLEDGEME:JT OF CONDITIONS <br />� <br />� <br />N <br />� <br />O <br />� <br />Y/ <br />O <br />a <br />The undersigned owner/applicanl hereby agrees to hold and save harm- <br />less the Cily ol Fverelt Irom any and all claims lor damages. costs. <br />eapenses. or causes ol action ihat may arise Uecause ol installa(ion <br />and maintenance ol the improvement or oUier righl�ol-way use hcreto <br />applied lor and further agrees to remove same upon notice Irom the <br />City and to replace puUllc property damaged thereby. <br />�GC� �� � z� �9� <br />APPlicant �� Date <br />CNORK NUTHORIZED BY ;HIS PERMIT MUST BE STARTC-D WITHIN <br />180 DAYS OF D,�TE PERf�11T IS ISSUED AND THEREAFTEH IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMI'f MAY BE <br />CANCELLED BY TI1E CITY UPON ANY STOPPAGE CF WORK ON ThI1S <br />PROJECT OVER 90 DAYS DURATION. <br />