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Date 1/24/90 <br />Application For <br />PUBLIC WORKS PERMIT <br />e-i..7t or Type Only <br />Select Homes <br />Owner <br />Applicant <br />Publr. Works Permll s <br />P109. Dept. + 90/23799 <br />Public Works Fee <br />Tool Fee $ <br />Less Appl. Fee Paid $ <br />Balance Due $ z C, <br />P.O. Box 708 Mukilteo,WA 98275 827-8196 <br />Mailing Address City Zip Phone <br />Mailing Address <br />City Zip <br />Nto• 7— <br />Describe Proposed Work New single family residence. Lot 13 Glenhaven Heights Biv 1 <br />W <br />Project Address (if known) - 9 • -- A �-�- r'J <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 />1 <br />DO NOT WRITE BELOW THIS LINE <br />PERMIT CONDITIONS <br />O <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 Constractior. <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1.800.424.5555. <br />4.ANY CHANGE IN THE DRIVEWAY CUT MUST BE APPROVED <br />O <br />BY THE PUBLIC WORKS INSPECTOR. <br />5.CONNECT DOWNSPOUTS TO THRU CURB DRAINS. <br />F.KEEP CITY STREETS CLEAN AT ALI, TIMhS. <br />7-ANY DAMAGE TO THE CURB AND SIDEWALK WILL HE REPAIRED <br />TO THE SATISFACTION OF THE PUBLIC WORKS DEPT. <br />O <br />am <br />Approved for Constructio ate <br />%!D -Sb <br />FINAL INSPECTION Date <br />Approved as Costrutted <br />everett PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />Phone: 259-8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hotd 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 installation <br />and maintenance of the improvement or other right-of-way use hereto <br />applied for and further agrees to remove same upon notice from the <br />City and to replace public property damaged thereby. <br />(:2� --a <br />Signature of Applica t Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />