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Date 4/1/94 <br />Application For <br />PUBLIC WORKS <br />Print or Type Only <br />Jay Derosier 12311 James Rd <br />G ��2-28 -4. <br />TO POSTI��G _ � �-�. <br />PERM�� <br />� <br />¢ <br />pO <br />O <br />Minnetonika MN <br />Mailing <br />Jeffrey deRonlet AIA 485-4400 <br />^r�"�"" Mailing Atldress <br />Describe Proposed Work NeW hOuse <br />Project Address (if known� 2407 56th St SW <br />Pu01ic Worke Pe�mlt • <br />l3 '� <br />Blap. Deo1. a ___ <br />Pubbc Works Fee <br />Total Fee S <br />LessApGl FeePaitl $ <br />S II� O t� �p I1J 6 I:eT—� Du—p-� � <br />U- . . <br />In ,-a Il] tl O�:t O C•J In O vF C�l <br />�`� `� O Ql .-� W CJ M O h N O� <br />P N M Y1 W .-r N C.1 1(7 <br />:9534�'" "'612 9S6-7Gf�3'" m N N <br />cv co x c� � 3I� <br />ori�c.ic�u�5_>a <br />�-' a x�"-. Zi r,:� �u-'�' � <br />a � � �hone <br />�`il o w .+ c� pQ <br />�ow."+i <br />3��,�� �.r•� <br />Lot 80 Powder M171 <br />Attach tour (4) copies of plans for proposed waP - Draw to scale and note the following as applicable: <br />• Property Lines <br />• Outline and dimensions of all existing and <br />proposed siructures on the lot <br />• Existing and proposed utilities <br />• Centerline of street <br />• Indicate North <br />• Show any proposed grading changes <br />� Show measurements <br />PERMIT (;ONDITIONS <br />1. +�I calls for inspection shall be made 24 hrs. in advance - phone 259-8810. <br />2. AH work shall be pertormed in accordance with this permlt and current City oi Everett Design and Construction <br />tandards and Specifications. <br />3. C;afl Location Underground Service �8 hrs, before you dig. TOLL FpEE NUMBER 1•800-QQ4-5555. <br />4. Instal rock construction eMran::e behind driveway as per city <br />standard a1r208 and erosion cortt� c! as directed by PubGc Works <br />Mspector. <br />5. Keep city stroets cban at al timas <br />8. Curb gutter and sidewak in the pW are new and undamaged, <br />arry damage thereto shal be repiaced at the discretion of fhe <br />Publc Works Inapector. <br />7• My shanye in the drivevaay cut must be approved by the PW In- <br />spector, widlh rt prop Ine ImNed to e�isting apron widlh. <br />8. Connect al rool, yard and driveway drains to storm droln <br />system provided to lot. <br />9• Adja�st water boYes to grade at end of construction. <br />10. Driveways shal be compbtey cured before driving on them. <br />npN�wcu no wnsuuc[ea <br />����PUBLIC WORKS DEPARTMENT <br />3200 Ceder Street <br />Everett, WA g82p1 <br />Phone: 259•8810 <br />ACKNOWLED6EMEN7 OF CONDITIONS <br />W <br />� <br />� <br />� <br />� <br />O <br />� <br />� <br />O <br />a <br />The underslgned owner/apVlicant hereby agrees to hold and save harm• <br />less the C;ty of Everett from any and all claims for damages, costs, <br />expenses, or causes of action that may arise beca�se of installation <br />and maintenar�ce of the improvement or other right-of-way use hereto <br />applied for arid furiher agrees to remove same upon notice from the <br />City and to replace public property damaged thereby. <br />S <br />Signatur plicant <br />Date <br />WORK AU IZED BY THIS PEqMIT MUST BE STARTED WITHIN <br />180 DAYS ATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTL URSUED 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 />