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Date ��19/93 TO POSTING �'Lq-R`� <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />John West <br />Owner <br />Owner <br />qpplicant <br />Describe Proposed Work <br />Address <br />Address <br />New duplex - Basic 223 <br />�� �a / <br />P�bhc worka Pa�mit • <br />eiaa oao�� � C41 6 <br />Pubi¢ Woihs Fee s <br />Tolal Fee <br />Less ApO� Fee PaiC S � �}-- <br />Balance Due t jQ/ - <br />City ��p Phone <br />Project.,ddresslitkaowN 5234 S 4th Ave Lot 3 <br />Attach lour (4) copies of plans for proposed work - Draw to scale and note the following as applicable: <br />• Property Lines <br />• Outline and dimensions of all ezis�in9 and <br />proposed structures on the lo! <br />• Existing and proposed utili�ies <br />e Centerline ot sireet <br />• Indicate Norih <br />• Show any propose� grading changes <br />• Show measureme�ts <br />PERMIT CONDITIONS <br />t. All cells for inspection sha�l be mede 24 hrs. in advanc� • phone 259•8810. <br />2. All work shall be peAormed in accordence with this permit end current City of Everett Design and Construclion <br />StanAerds end Specifications. <br />3. Call Locatlon Underground Service 48 hrs. beforo you c:id. TOLL FREE NUMBER 1-800•424•5555. <br />4. Inatall rock construction entr•ance behind driveWay as per city <br />etandard i1208 and eroaion coni,rol as directed by Public Worka <br />Ittspector. <br />5. Keep city atreeta clean at a.11 timea <br />6. Gtiirb gutter and aidewalk in the olat aro new and undamaged, <br />any damage thereto ehall be replaced at the discration of the <br />Public Works Inapector. <br />7. Any change in the driveaay cut civat be approved by the PW In- <br />epector, width at prop line limited to exiating apron Hidth. <br />8. Connect a).l. roof, yard and driveway drains to storm drain <br />syat>m provided to lot. <br />9. Ad,iust water boxe� to gcade at end of construction. <br />10. DriveWays ahall be..�mpletely cured before driving on them_ <br />FINAL INSPEGTION '" <br />Approved as Consiructed <br />/Ar�PUBLIC WORKS DEPARTMENT <br />3200 Cetlar Sireet <br />Everett, WA 98201 <br />Phone: 259-8910 <br />ACKNOWLEDGEMEN' OF CONDITIONS <br />� <br />� <br />� <br />a <br />The undersignet owner/applicant hereby agrees to hold and save harm- <br />less ihe City ol Everel� Irom any and all daims lor damages, costs, <br />/�� expenses, or causes of action that may arise because ot installation <br />and maintenance ol Ihe improvement or other right-obway use herelo <br />applied lor and turiher agrees to remove same upon notice Irom �he <br />Date City and to replace public property damaged lhereby. <br />Date <br />y�y��......_ _...�.._- <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS �SSUED AND THEREAFTER IS TO <br />?E DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />(;4NCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />