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Date 6-14-93 <br />Application For <br />PUBLIC WORKS <br />Print or Type Only <br />y.�r�yI• % <br />� J �� ��— � I 21tl9 DePirk' Pa,�n9� � I 1 <br />P E R M I T I?uClic Worka Fee — <br />To1alFee S <br />TO POSTING � 73 �, s/ Le55Appl FeePaN S � <br />Balance Oue s J/� <br />NI"HOLAS SCHMITZ 3420 102ND PL SE <br />OWNER <br />Applican! <br />Describe Proposed Wo�k <br />Prolect Address (if known) <br />Mailing <br />NRW H(111SF. <br />City <br />4521 <br />Zip Phone <br />Zip Phone <br />.L '7. _ Co�ln,�i,nl <br />Attach four (4) copies of plans for proposed work - Draw to scale and note tne following as apG�`�:able. <br />• Property Lines • Centerline of sireet <br />• Outline and dimensions of all existing and • Indicate Norih <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 lhis permit and current City o( Everelt Design and Construction <br />Standards and Specifications. <br />3..^.all Lc:.ation Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800•424•5555. <br />4. Inatali rock ronstrurtion entrance behind driveway as per r.ity <br />s`andard p208 and erosion control as directed by Public Worka <br />InsFectnr. <br />5. Keep city streets rlean at all times <br />6. G13rb gutter an� sidewalk iti the plat are new and undamaged, <br />any damage thereto shall be replaced at the discretion of the <br />Public Works Ins�ctr�r_ <br />7_ Any change in the driveway cut muat be approved try the PW In- <br />spector, width at prop linF limited to existing apron Width_ <br />8. Connect all roof, yard and driveaay dr.ains to atorm drain <br />system provided tr� lot. <br />9. Adjust wat�r bcixes to grade at end uf r_nnstrurtion_ <br />10. Drivecaays sha11 be rompletely cured before driving on them. <br />FINAL INSPECTION <br />Approi�ed as Constructed <br />/A�I�� PUBLIC WORKS DEPARTMENT <br />3200 Cedar S�reel <br />Everett. WA 98201 <br />Phone:259•8810 <br />7- � y3 <br />Date <br />r-�� -s�r- <br />Date <br />� <br />W <br />H <br />� <br />� <br />� <br />O <br />� <br />� <br />O <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harm� <br />less the City ot Everetl irom any and all claims for damages, cosis, <br />ezpenses, or causes ot action that may arise because of installation <br />and maintenance ot Ihe improvement or other right-of-way use hereto <br />applied tor and further agrees to remove same upon notice from the <br />City and to replace public property damaged ihereby. <br />( Q / <br />��,,� �.�A -'�%% F'-Sd -93 <br />Signa ure ol Applicant Date <br />WORK AUTHORIZED BY THIS PEFMI'i MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS t�SUED AND THEREAFTER IS TO <br />RE 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 DURA � ION. <br />