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Date ��19/93 <br />PUBLIC <br />Print or Type Only <br />John West <br />Owner <br />Owner <br />qpplicant <br />Describe Proposed Work <br />Prolect Address �if known� <br />r <br />� SO FOSTII�G " � "�''� <br />A�lication For <br />VI�ORKS PERMIT <br />O p p ^� o p p p <br />x V�I O O O U l O O O O <br />6. <br />� �.�+��~c «�.rno <br />N NM M MCJ <br />Puoi¢ weds Permit � � � / <br />eiae Dao�-+ C <br />Po01¢ Works Fac <br />Total Fee S <br />Lrtss Aop� Fec Paid S <br />Dalance0ue $ ��l_ <br />MlilinqAddress City Zip Phone <br />New duplex - Basic 223 <br />5226 S 4th Ave (Lot 4 <br />Attach four (4) copies of plens lor proposed work - Draw to scale and note the following as applicable: <br />• Property Lines <br />• Outline and dimensions oi all existing and <br />proposed structures on the lat <br />• Existin9 and proposed ulilities <br />• Centerline of street <br />• Indicale Norlh <br />• Show any proposed grading changes <br />• Show measurements <br />PERMIT CONDITIONS <br />1. All calls for inspection shell be made 24 hrs. In advance • phone 259•8810. <br />2. All work shall be pertormed in accordance with this permit and current City ot Everett Design and Construction <br />Standards and Specifications. <br />a. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800-424•5555. <br />4. Inatall rock conetruction entrance behind driveway as per city <br />atandard 1t208 and eroaion control ae directed by Public Worka <br />Inepector. <br />5. Keep city streeta clean at all times <br />6. Qu�b gutter and aideWalk in the plat are new and undamaged, <br />any damage thereto ahall be replaced at the discretion of the <br />Public v7orka Lnapector. <br />7_ Any chenge in the driveway cut must be approved by the PW In- <br />epector, width at prop Line limited tu eziating apron width. <br />8. Connect all r�oof, yard �nd driveway drains to atorm drain <br />syetem provided tn lot. <br />9. Adjuat water boxes to grade at er,d of construction. <br />10. Driveways ahall be completely cured before driving on them. <br />7 <br />lo� <br />� <br />FINAL INSPECTION <br />Approved as Conslructed <br />�A��PUBLIC WORKS �EPARTMENT <br />3200 C�dar Streel <br />Evereu. WA 98201 <br />Phone�259�8810 <br />Date <br />ACKNOWLEDGEMENT Cf CONDITIONS <br />W <br />� <br />N <br />� <br />O <br />� <br />� <br />O <br />a <br />The undersigned owner/applicant hereby aorees to hold and save harm- <br />less Ihe City of Everett Irom any and all claims lor damages, cosis, <br />expenses, or causes of action that may arise because ot installation <br />and maiNenance ol ihe improvement or clher right�ol�way use hereto <br />applied lor and further agrees to remove same upon notice Irom the <br />City and to replace pubfic properry damaged thereby. <br />�6��i��� <br />.� 0 <br />ture oN(ppliwnt Date <br />RK �UTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />8E DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MA1' BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />� PROJECT OVER 90 DAYS DURATION. <br />