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, <br /> � <br /> Date�� l��� ���;:A �F4U_. _�—���-� v,�o,�c,���.o�•,.�m�i. ��� �' – <br /> om�i o�oi . i7816 _ __ — <br /> ��H Application For <br /> ��'� PUBLIC WORKS PE�'�VVIIT '°°"""°`""eC S <br /> Tol�l Fee <br /> ��� Le;s aoo� Fee Paia S� <br /> H <br /> Baiance Due 5 <br /> H�� Print or TyPe Only <br /> � z� <br /> H�1 <br /> O x O Da11y Homes Inc 3240 Eastlake Ave E '?200 Seattle, 47A 98102 328-3770 _ <br /> '�J H'sJ Zip Phone . ��� <br /> V1 H Owner MaiNng ACtlress City <br /> y r ��=�% <br /> xz <br /> lTl O� Owner -- <br /> H d QIY Zip Phonc. <br /> � �� Applicant Mailing Address <br /> H/1 Cj]O <br /> y�V � <br /> �""� Describe Prouased Work New SFR — <br /> 9 H� -- <br /> r z <br /> HH <br /> n C7 y � <br /> e�r � <br /> � Prolect Addres�(il k�.iownl -- 41��.P1 (T t 4 f 4'lvarhaf.uk <br /> Z H[n <br /> y �� AtIaU� �our 14)copies ol plans lor pronosed xork Driv:lo s[al[antl nole the lollovnn�3 a5 applicab�e' � <br /> � o Pro;:erry L�nes • Centerline ol sireet �A <br /> C Outline and tlimensions ol all ex slinq antl • InUiwle North V� <br /> p�oposed slrucWres on the lot • Show any proposetl 9ratlm9 changus <br /> � Existing and proPosed uiilitie5 • Shcw measuremems M <br /> W <br /> � DO NOT WPITE OELOW THIS LWE � <br /> '�+ PERMIT CONDITIONS � <br /> 1.All calls lor inspectiun shall be made 24 hrs.in advance�phone 259•8810. � <br /> �� 2.All work shall 6e pedormed in accordance with Ihls permit and cunent City ol Eierett Desi9n and Construction <br /> Standards and Specilications. <br /> A—s 3.C�II Location�nderground Service 48 hrs.helore you dig TOLL FREE NUMBER 1•800-424•5555. �y <br /> 4. Install rock construction entrance behind driveway as per citY t <br /> i� standard 1t208 arvi erosion control as directed by Public Works � <br /> Inspector. <br /> '�' 5. Keep city streets clea� at all times <br /> ++ 6. Curb gutter and aidewalk in the plat are new and undamaged, � <br /> any damage thereto cthall be replaced at the diacretion of the <br /> t'ubl.ic Worka In�pector. �^ <br /> 7. Any change in the driveway cut must be approved by the PW In- �i� <br /> '�'s apecY.or, tvidth at prop line limited to existing apron width. � <br /> 8. Connect all roo£, yard and driveway draina to atorm drain <br /> - syeLam provided to lot. a <br /> �� 9. Adj�:at water boxes to grade at enJ o£ construntion. <br /> 10_ Ariv��ways shall be completely cured be£ore driving on them. <br /> . �� /� ACKNOWLEDGEMENTOPCONDITIONS <br /> /��l�� <br /> � y The untl�!rsi9neA owner,�apphcanl hereby a9�ecs to hold an�savc harm� <br /> � ✓ ° -- —- -- -'"—� �ess Ihe City ol Evereit I�om any and all claims for tlamages. cosls. <br /> � q/�L�� � ' � � ezpenses. or causes of action that may arise because ol installation <br /> –r� " , and maiNenance of �he improvemeni or other ric�ht�of-way use hereto <br /> ' . .5,� r� ppplieA �or and lurthcr a�rees to remove same upon notice hom �hc <br /> Apnro� d lor Const r pction ��1e Cily and to replace Public proUerty damac�ed thereby. <br /> / / <br /> I 'Y- 5? � 7 <br /> �° l� ��.��� � . <br /> PINALINSPECTION Datc .+s p��i, <br /> Fpprovetl;ls Conslructed Sf� a rz of Applicanl � <br /> � <br /> � WORK AUTh10R2ED BY THIS PERMII MUST BE CTARTE I <br /> +�� PUBLIC WORKS DEPARTMENT 1 E30 DAYS OF DATE PERMIT IS ISSUED AND THER[AFTER IS 1 O <br /> � 3200 Cedar Street F3E DILIGENTLY PURSUEG TO COMPLETION. THIS PERMIT M�Y BE <br /> Everett N'A 9B201 CANCELLED BY THE GTY UPON ANY SiOPPAGE OF VJORK ON TNIS <br /> Phnnc�.259�8810 I Ff{OJECT OVER 90 DAVS DUFATION. <br />