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i <br /> � <br /> < <. <br /> l <br /> Date�90 � 1 P�o�,�wo�ksPa,m,�. .�C_', G> <br /> r.�.-, Application For ��'/ !�f�`��'�' � � eiao oeo+. . 90/233� . <br /> PI�LIC WORKS PERMIT �°°��W°�k=F�� - ' <br /> 0 iotai Fee 5 <br /> O I� tessnnn� cco-p;,,n � <br /> 0 0 0 0 0 � o 0 0 o c� o n o 0 0 0 . <br /> Print Or �ype On� u: o n in o o � �'i � u-i o o �+ v� o n o 0 0 o,i,��e o�� S 2G i <br /> �Y' 00 � O 00 � O �OliJO N1 � 00 000 N <br /> +-� CJ �O T W C'J f! tfl .-� � [� �7' P M u! CJ �O N.� lf) .� �Y' , <br /> If7 W� W ni W �O rl ai {n w M ut +n ti! W �O .-� .-� ' <br /> .�-�i .-a � O W � .-i pp � u Cl � � � I <br /> _ Select �I�mes, Inc. 'm° P-q.��'7�8 Muki]Lteo �� 4��,75 827-8196 <br /> Owner � ��.` � � _ � ����res� w � c� c� x �� w o w .�-� Z�3 Pho�ie <br /> .. oow�' c� p i- p omc.� " n � �- oa � oi� <br /> � O J W �L O W .�+ 2 dOJJ W -1 i< ¢ o W .-iiS <br /> OW71ET sc �] � n'l � ac Ul ti Cu � 3 7t fil ii Z L ii� [� 3 3� Ul .-. iiw [� <br /> Applicant Mailing AAdress City Zip Phone <br /> N.,.z <br /> Describe Proposed Work New single family residence, Lot14, S Glenhaaen Heights, p,�-� <br /> �':�Z ��TFt �.—/�G� S l�( � ��� <br /> Projec�Address lii known) L <br /> r <br /> Attach four(4) copies of plans for proposed work- Draw to s�ale and note the followino as apP�icable: � <br /> • Property Lines • Centerline uf sireet � <br /> • OuUine and dimensions of all exis�iny and • Indicate Norih <br /> proposed shuctures on the lot • Show any proposed gradinc�changes <br /> • Existing and proposed utilities • Show measurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMITCONDITIONS O �I <br /> 1.A!1 calls(or inspection shall be made 24 hrs.in advance-phone 259•8810. � <br /> 2.All work shall be peAormed in accord3nce with this permit and current City of Everett Design and Construction <br /> Standards and Specitications. <br /> 3.Catl Location Underground Service 4D hrs.betore you dig.TOLL FREE NUMBER 1•800•424•5555. � <br /> 4.ANY CHANG6 IN THE DRIVEWAY CUT MUST BE ,�,PPROVED O <br /> BY THE PUBLIC WORRS INSPECTOR. <br /> 5 . CONNECT DOWNSPOUTS TO THRU CURB DRAINS . <br /> b . REEP CITY ST!iS6;TS CL6AN AT ALL TIMES. � <br /> 7 .ANY LAMAGH i0 'fHE CURB AND SIDEWALK WILL BE REPAIRED � I <br /> TO THE SATISFACTION OF THE FUBLIC WORRS DEPT. <br /> O ' <br /> a ; <br /> � <br /> � <br /> ! ACKNOWLEDG[MENTOFCONDIT�QNS , ' <br /> "�jV The undersigned owner/applicent hereby agree= �o hold and save harm- i <br /> — less lhe City ol Everett Irom any and all cl�,r... �or damages, costs, j <br /> 1 � / ezpenses, or causes of action that may arisr� hc;�.use of installation 'i <br /> �.I ����/� ,{ �' � / �, and maintenance of Ihe improvement or Mhci yghrol-way use herelo '� <br /> ( ��� applied for and further a9rees to remove sai❑e pon notice irom the <br /> Approvei for Conslrucf o ate Cit and to replace public property damaged ihe by. <br /> / <br /> ��/�/ ��y �/ �'�l��l <br /> FINAL INSPECTION Date <br /> qpproved as Constructed ignaWre of A;,pl�cant � Date <br /> everet[ PUBLIC WORK;DEPARTMEN7 WORK AUTHOFtIZED �3Y THIS PERMIT MUST BE STARTED WITHIN <br /> � 'i2�OCedarSireet 180 DAYS OF DA'IC PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Evere�t,WA98201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BC- <br /> Phone:259-8870 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br /> � <br />