Laserfiche WebLink
140 <br />Date44 <br />A ;ipLcation For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Public Works Permd a 99 /� O <br />Bldg Dept. • i 97a <br />Public Works Fee § <br />Total Fee <br />Less Apol. Fed Paid S —.�— <br />Balance Doe $ <br />Phone <br />Mailing Address <br />Describe Proposed Work <br />Project Address lit known) <br />ulty ciy <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the following as applicable: <br />• Property Lines • Centerline of street <br />• Outline and dimensions of all existing and • Indicate North <br />proposed structures on the lot • Show any proposed grading changes <br />• Existing and proposed utilities • Show measurements <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hrs. in advance - phone 259.8810. <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and Construction <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before yotl dig. TOLL FREE NUMBER 1.800-424.5555. <br />4. Use driveway curb -cuts provided or get approval from the Public works <br />Inspector for relocation. Any new driveway shall be installed per City <br />Standard #307. Unused driveways shall be taken out and replaced with full <br />height curb & gutter. <br />5. Use storm drain system for down -spouts from roof top. <br />6. The applicant shall be responsible for replacing any curb, gutter or side- <br />walk broken during the construction process. <br />z <br />0 <br />CIO <br />0 <br />Oil <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the City of Everett from any and all claims for damages, costs. <br />expenses, or causes of action that may arise because of install& <br />/3- J'��5�. and maintenance of the improvement or other right-of-way use hi, <br />�f applied for and further agrees to remove same upon notice fror <br />Ap for Con tructfIc City /d to replace puulic property damaged thereby. <br />FINAL NSPECTION Date Date <br />Approved as Constructed Signature of Applicant <br />WORK AUTHORIZED BY THIS PERMIT MUST BE S ARTED WITHIN <br />everett PUBLIC WORKS DEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />3200 Cedar Street BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />Everett, WA 98201 CANCELLED BY THE CITY UPON 1NY STOPPAGE OF WORK ON THIS <br />Phone: 259.8810 PROJECT OVER 90 DAYS DURATIJN. <br />