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-, ��l -=>�.� <br /> �I—_, I —G�I "� �u,��rWo•��s,�nrn,u< � <br /> Date ��18 91 27748� <br /> ein�� ocm • <br /> � � Applicalion For _ <br /> b � � PUBLIC V`VORKS PERIIAIT ""°'"`NO1M9`°` § <br /> ,o,,,F��. <br /> C�' N 1 �-- LesS PpOL Fen Pa 4 `S li <br /> TO POSTING :/i� y a , o, 5 �_�" <br /> � � : - � � - �� � � � - I <br /> � � Print or Type Only; I <br /> b � N .. •. ��' . �I. I <br /> � z � Pairmont F'omes :219b2 38th Ave ld ,;Brier 9803G 356-2435 Phone i <br /> Qy u��. �- ' hlaiNng,Ad�lrg$s Ciry Zip <br /> Owner r� � <br /> r i:� <br /> � (1 q O i � r i - :[ � j I <br /> h+ da r; t u� ,i .` � n _ <br /> � � — � Mailinc�Address CI�Y ZiP Phone li <br /> � F.pplicant <br /> M I <br /> y Neca sfr 1642SF <br /> ~ Describe ProPosed Work <br /> � �y t9 <br /> O y <br /> y W <br /> z - �� -��, �� � �..- <br /> Project Address(if known) <br /> � <br /> Attach four(4)copies of plans lor proposed work- �raw to scale and note the lollowing as applicable: � <br /> • Properry Lines • Centerline of street <br /> • Indiwte North <br /> • Outline and dimensions of all existin;�and � Show any proposed grading changes <br /> proposed structures on the lol � $how messuremen�s I� <br /> • Existing and proposed utilities W <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS � � <br /> 7.All calls for inspection shall be made 24 hrs.in advance-phone 259•8810. <br /> � �1 2.All work snall be peAormed in accordance with this permit and current Ciry ol Everett Design and Consiruction <br /> � ��' Standards and Specifica�ions. � �, <br /> 3.Call Location Underground Service 48 hrs.belore you dig.TOLL FREE NUMBER 1•800•424•5555. <br /> 1 4 . In�tall rnrk r.onstrur_tion entxance bFhind dri.veway a^ Per r.itv O <br /> �s standard N?.08 and erosi.�n r.ontro] as direcY.ed bv Publir_ Works 'I <br /> �� In�per.tor. <br /> - 5. Keep r,iY.y streets cl.ean at al.l ti.mes ■ �,, <br /> g. ri�rb gui;ter and si�lewalk in the plat are ne.w and undamaged, � <br /> any damaeP thereto sha77. he, rPt�7aced at Y,he discretion of the I ` <br /> Puhlir. W�rks InsPector. � <br /> I O <br /> 7 . AnY r_han�e in th� dri.vewav rut mu�t be apPr�vPd hv Y,he Publ.ir_ <br /> 'v7orks Inepertor. � , <br /> 1 S. Ti.�htl.ine a7']. roof, yard an��rtlf�wae\Srconst v�tc.a�o s�- <br /> ��, - <br /> 9. Ad,i>>=1. wat,er b�xes to Erade at end of constrvction. <br /> L0. Dri.veways shall be comPletPly rure�3 before drivin� on them. <br /> 4 ` � ACKNOWLEDGEMENT OF CONDITIONS <br /> ., �- - /�� The undersi9ned o�vner/applicanl hereby agrees to hold and save harm- . <br /> � � I�ss the City ol Everett Irom any and all clz:ms lor damages, cosis. <br /> expenses, or causes of action ihat may arisc: because of installation <br /> _ � �O _q . O� 1 and m�imenance ol the impro�ement or other right�of-way use hereto <br /> �J app ied for �nA furthcr ac�rees lo remove same upon notice from the <br /> �t�� � � Date C�t nd to replacc�ub'ic properry damaged thereby. <br /> ApprovedforConsV_ tio�� <br /> � �4�%l"f�G.� � /-�C �'z- _ _-�� - � 0�9�1_- <br /> FItJAL INSPECTION Date . -- - Date . <br /> � i�r re of Applicant <br /> Approved as Constructed PK AUTHOFIZED 6Y THIS PERMIT MUST BE STARTED WITHIN <br /> PUBLICWOFKSD[PARTMENT 1b�1�DAVS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> ���� 3200CedarStreel PE DILIGENTLY PUR�UED TO COMPLETION. THIS PEFiM1T MAY BE <br /> Everelt,WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259�8870 PROJECT OVER 90 D.4VS DURATION. <br /> � <br /> I <br /> I <br /> I <br />