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i.4. � <br /> � <br /> ! ��� � <br /> � � �� �1 _ r yyy <br /> a�� . . . . �. � . .-. -. .. � � <br /> ��� -- . , I <br /> `-, <br /> ��� �BY.0 ,_A_o� ��� TO POSTIN6 � '��' �'�— r�oucwo.e�r«.miu ��- . V L �_ I <br /> ei,q oew • 92/35278 <br /> Fpplication For <br /> ��� PUBLfC W(�RKS PERMIT °°°°`w°""" : <br /> ioblF�+ <br /> IeuA00�PoeP�iE S <br /> m �.. B��enceDuo s <br /> f-i t�a� Print or TyPe Onry . � ' ':' <br /> p• c� °' <br /> y � ,� .n ..^ O fY� , :'� 4] <br /> �GH ' <br /> M Hanabrook Inc E. 4020 Main Spokane WA 99202 (504) 534-U644 <br /> ��� Owner MaiNn,g�AGdresS �� ,,, - i CtlY � ... Z�P Phone <br /> r i, ' <br /> � � r �.i <br /> iGi <br /> ����'! OH[10L • f. r'� -� � I <br /> APPIiCent Mailing�Address � CdY Zif Phone � I <br /> y <br /> DneCribe Proposetl Work neW SFR �Q� .3a � �i <br /> .i:�. . �j. � <br /> �� ! <br /> , W , <br /> , '�� �5�; _ �0 001 - � � <br /> ("'� � Prolect Address(it known) a� � ��'� `�1�� �`/ '� <br /> ���t,� ' Attach tour(d)copies of plans�or proposed work� Drew to scale anA note ths lollowing as applicable. � <br /> .;j(�r"��E�r • � • Property Lines • CeNerline ol street � � <br /> � • Outline and dimensions o1 all eziating anJ • Indicate North � <br /> ' proposed structores on the lot • Stiow any nwposed gratling changes <br /> A Existing and proposed utilities • S iow measurements M <br /> DO NOY W��!TE BE— L--S LINE O <br /> ��,� <br /> � PER�IIT CONDITIONS <br /> � 1,All calls tor inspection shall be mede 24 hrs.in advance-phone 259•8810. � <br /> �� � 2.All work snall be pedormed m eccor0acco with thi;perm�t and current Ciry of Evere9 Oesign and Gonstruction i <br /> StanAerds and Specifications. <br /> ��' 3.Call Locetion Undergrouno Service 4B hrs.belore you dig TOLL FREE NUMBEA 1•800�424•5555. � <br /> i 4 . Tnstal ] rock cnnstrurtion entrance behi.nd drivewaY as per riY,Y O <br /> I etandard ri20H and erosion r.ontrol as direrted by Puhli.c Worke <br /> Inspertor. <br /> ', �_� �i 5. Reep ci.tY atreete c7.sai. at al] Y,imea � <br /> � 8. Cvrb ?utter and eidewalk in the pJ.at are new and undamaged. <br /> � an�� damage thereto shall be replared at the discretion of the //� <br /> Puhlir Worke TnAper.tor. �// <br /> I "� 7 . Anp r.h�nge in the drivewav r_ut muet be apFrnved 6p tha Pvb] ic O <br /> { Worke Inspertor. <br /> +i B. Ti�htline a71 ronf, yard and driv=way drai.na to storm drain /� <br /> st;ube aC Uack aide of Eidewalk. `� <br /> (I �'�' 9. Ad.ivat water hn,;es tn �+rade at end of conetruct+on. <br /> 10. DrivewaYe ahzll h� r�mplPt.elv cur�d Uefore drivinq on them. <br /> � ACKNOWLE'GEMENT OF CONDITIONS <br /> � The undersi9ned owneda�.plicant hereby agrees ic hold and save harm� <br /> ��. less the Clty of Everett trom any and all claims lor dama�es, costs, <br /> � / � erpenses. or causes of action ihat may arise becaus� of instaltation <br /> , . � I,1, � �� �-, ( ` �: I L and maintenance ol the imFrovement or other �i�hbol-way use hereto <br /> � � apolied lor and furihnr agrees lo remove same upon notice irom ihe <br /> App�oved lor Gonstructi9r(,/ � Uate Ciry and fo replace public property damageC ihereby. <br /> i� <br /> /- `. C �_.--- ') <br /> �� (C�/L % �C � / / � � R�q �/ � j�-- <br /> � l � _�� <br /> FINAI INSP[CTION Date ' �— �" — <br /> Appioved as Ccnstructed S�ynaturc of Applicant Date <br /> WORK AUTHORIZEU B� TI?IS P[RMIT MUST BE STARTED W�THIN <br /> ��i.'' PUBLIC WORKS DEPAR7MENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTFfl 'S TO �, <br /> 3200 GeOar Street BE DILIGhNTLY PURSUED i0 COMPLETION. THIB PERMIT MAV BE <br /> Bverett,'NA 9A207 CANCELLEO BY THE CITY UPON ANY STOPPAGE OF WORK OR THIS <br /> Phone:259�8810 PROJ[CT OV[R 90 DAYS DURATION. , <br /> ' <br /> ____--___— '� <br />