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� �plication For ������9� <br /> PUBLIC WORKS PERMIT Date <br /> PUBLIC WORKS DEPARTMENT Public Works Pertnit X _J/�S/ <br /> 3200 Cetlar Street <br /> Everett.WA 98201 259-8810 Building Permit#__ <br /> TYPE OR PRINT ONLY Public Wcrks Fee$_ZO �� <br /> �onnie Biddle P.O.Box 3251 Everett, WA 98203-8251 (425 ) 2525805 <br /> Owner Mailing Address City Zip Phone <br /> Ramo ac ahoVP <br /> Applicant Mailing Address City Zip Phone <br /> DescribeProposedWork Construct a drivewa alon West side of residence � <br /> remove material(qrass and dirt) qrade to level w. ti street, � <br /> ♦�� <br /> V♦ <br /> PROJECTADDRESS(ifknown) 3111 Tulalip Ave � <br /> Attach four(4)copies of plans for pmposed work-Draw to scale and nme the(ollowing il applicable: O <br /> •Property Lines 'Outline and dimensions of all existing and proposed strudures on the lot •Eaisting and proposed uti�ities <br /> •Cenlerline of stre±t •Indicate North •Show any proposed grading changes •Show measurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS: � <br /> 1.All calls(or inspection shall be made 24 hours in advance-phone 259-8810. O <br /> 2.All work shall be peAormed in accordance with this permit and current City oi Everett Design and <br /> Construction Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMRER 1-800-424-5555. � <br /> V♦ <br /> � <br /> 1i-iii-'r'� - �Zrl, � <br /> ii .�7��9 <br /> D�iIVE �O.GG <br /> ��OTA� 20.00 <br /> �.�i;�i, ... , <br /> _ �,i�3C�� :. <br /> �� <br /> ACKNOWLEDGEMENT OF CONOITIONS <br /> / The undersigned ownedapplicant hereby agrees to hold and save harmless <br /> „�.�C ���� /� �¢�7 the City of F+eretl trom any and all claims for damages,wsts,ezpenses,or <br /> P.pproved for Con ructAn � Dat 7 causes of aclion that may arise because ol installation and maintenance ot <br /> /' / theimpmvemPntorotherright-ol-wayuseheretoappliedforandfuriheragrees <br /> :%� � b remove sa re upon notice from the Ciry and to replace public property <br /> ��� �-- � � �� dama ereGy. <br /> FINAL INSPECTION 'Date �/� <br /> Approved as Constructed ��� /'/� /J /��� � -�J <br /> / C 7 <br /> Si ure of AD licant OJ ���� Dat� <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE RMIT IS ISSUED AND THEREAFfER IS TO BE DILIGENTLY PURSUED TO <br /> COMPIEfION.77115 PERMIT MAY 8E CANCELLEO BY THE CITY UFON ANY STOPPAGE OF WORK ON 1HIS PROJECT OVER 90 DAYS DURATION. <br />