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°: � � �QSTING �s � <br /> a< <br /> 2—G�i�lf/. '� '� ruoLc WorMs Parmu M <br /> Date '" 4361 <br /> . Bldg.Depl.• <br /> Appl'cotion Fer, <br /> PUBLIC WORK; PERMIT PubTo�IpgeFea s — <br /> Q Less AOPI.Fee Paia �� <br /> O <br /> � O O O O G O tl Balance Due S — <br /> Print or Type Unly �� � � " � "' � � `�� � � <br /> ti <br /> �n o� .. 00 � r� v�, oroc��� <br /> `� .�q � �Mw � � � e�imm <br /> W eh .+ <br /> Rob Hollin;;sworth 6605 N Me,ado��#lale Rd Lvnn�od�A 98037 743-4666 _ <br /> Owner Mailing�d1'e�'. � �_ ��� �i � � Z�P Phone <br /> � O G9 1 f:J CG 3 U W O � .-� C.l <br /> ,-i GC) � Ll0 U� ? O V- 03t� W <br /> Breakwater Development Inc � satl���a6�- �JW' � o � 3 $ u�i ^ rs-' <br /> Applicant Mailing Address City Zip Phone <br /> Describe Proposed Work new house - - � <br /> Lot 6 Eisenhower Court � <br /> - _ W <br /> Proiect Address(if known� 10011 25th Ave SE _ � <br /> � •� �ch four(4) copies ol plans for proposed work- Draw to scale and note[he lollowing as applicable: � <br /> • Property Lines • Centerline of street � <br /> • Outline and dimensions ot all existing and • Indicale Norih <br /> prcposed structures on the Icf • Show any proposed grading changes <br /> � Existing and proposed utilities • Show measuremenis M <br /> W <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1.All calls for inspeclion shall be made 24 hrs.in advance•phone 259•8810. � <br /> 2.AI�work shall be performed in accordance with this permit and current CiIY of Everett Design and Construction <br /> Standards and Specifications. � <br /> 3.Call Location Underground Service 48 fvs.before you dig.TOLL FREE NUMBER 1•800•424'S555. <br /> �. Instai rock consfruction eMrence behind driveway as per city O <br /> standard a1t208 and erosion control as directed by PubAc Works <br /> Inspector. <br /> 5. Keep cily streets clean at aA times � <br /> 6. Curb gulter aad sidewak in the plat are new and uadamaged, <br /> any damage thereto shal be rep�iced at t;ie discretion of the � <br /> PubYc Works Inspector. <br /> 7.Any change in the driveway cut must be approved by the PVd in- O <br /> spector,width at prop Yne Ymited to existing apron widlh. <br /> 8. Connect al roof,yard and drivtway drains to storm drain � <br /> system provided to bt. <br /> 9.Adjust water boxes to grade at end of canslruction. <br /> 10. Driveways shal be compktey cured before driving on them. <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> C(C� The undersigned owner/applican' hereby agrees to hold and save harm- <br /> � less the Giry of Everett from any and all claims for damages, costs, <br /> expenses, or causes of acti��. lhat may arise because of installation <br /> � 3 _ 3.. �YL1 and maintenance of the impro�ement or other righhof-way use hereto <br /> � � applied for and further ag�ees lo remove same upon notice irom the <br /> Appr or Cons n � / �a�� City and to plac uhlic proper damaged thereby. <br /> C��� / / - C .0� � <br /> �/� � �3 �5 �� 4 <br /> FINAL INSPECTION Date y�e <br /> Appro•�o' as Construded Signat e of Ap I a t <br /> WORK AUTH IZED BY THIS f'ER IT MUST BE STARTED WITHIN <br /> /'4,~� PUBLICWORKSDEPARTMENT 180 DAYS F DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> �` 3:.00 CederStreet BE CILI NTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Everett,WA 9B2U7 I CAIJ� LL ED BY THE CITY UPON ANY S70PPAGE OF WORK ON THIS <br /> Phone:e59�8810 pROJECT OVER 90 DAYS DURATION. <br />