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ApplicationFor TO ���TING�� f 81�� �- <br /> � �� <br /> PUBLIG WORKS PER�VIIT Date 3/26/96 <br /> PUBLIC WORKS DEPARTMENT Public Works Permit p �!�/Z 7 _ <br /> 3200 Cedar Street <br /> Ev�>;ett,Wqg8201 259-8810 � <br /> Building Permit q__51 714 <br /> IYPE OR PRINT ONLY Public Works Fee$. jQ9� <br /> COUNT&'_rF700D HOMES i4410 BFT—Rrn un RFirrVUE 9R007 fi49_ <br /> Owner Matlmg Address �i� - R 1 59 <br /> Y Z�P Phone <br /> U', <br /> Applicant �+ailing Address �i � � <br /> tY ZP Phone <br /> Describe Proposed Work _ NEW hOUSE — BASIC 1156 <br /> f �:K <br /> al.Ufi t1144.50 � <br /> . PROJECT ADDRESS(if known) 42 � � <br /> � P.ttach tour(4)copies of p!ans for proposed work-Draw to scale and note the following if applicable: �?I�! ��� W <br /> � � •Property Lines 'Outline and dimensions of all existing and proposed structmes on ihe�ot •Existing and p���es O <br /> "Centerline of street •Indl te North •Shoe�any pmposed grading changes •Show measuremens 1�RTER f105.00 <br /> DO NOT WRI'fE BELOW THIS LINE c�� y,.ro�� � <br /> PERMITCONDITIONS: s�� �.� � <br /> 1.All calls for inspection shal� be made 24 hours in advance- phone 259-881G. p{E� �1��� <br /> 2. All work shall be performed in accordance with this permit and current City of Everett Design and O <br /> Construction Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. beiore you dig. TOLL FREE NWMBER 1-800-424-5555. � <br /> �. Keep city she�ts clean at ;ill 6mes. � <br /> 5• Curb guttnr a��d sidCWiIIIC W Ut2 pIBI :11'B IICW .{11(I UII(I;1�118�C[I, ;my da�nage qirrelo shall br replaceJ at th O <br /> discretion o1'Ihe F'ublic Works Inspector. /� <br /> ��• �nr ch:+nge ui the drivewav ci,t must be approved b�- the PW inspector, widdi at prop line limited to ,i <br /> cxis6ng apron width. <br /> ' Adjust water boxes ro grade at enJ of consmic6on. <br /> 3. Driveways shall be completely� cured before dtivin�on them. <br /> �. Rooftop drainage shatl be discharged: <br /> ' ro the sitc's stortn drain .rystem (�rivate or pub6c) <br /> • to a rosidrnlisl roof downspout system Josigncd per scction 4•9.4 of ll�r cily stat�dards <br /> • onto spiash blocks <br /> fhe method selzcted will bz subject to PubGc Works lnspector approval. <br /> �� <br /> . <br /> � � � � ACKNOWLEDGEMENTOFCONDITIONS <br /> The undersignetl owner/applicant hereby agrees to hold and save hartnless <br /> the City of Evere:i from any and all claims for damages,costs,expenses,or <br /> Approved for C structiQn pa�e causes of action that may arise because of installatlon and maintenance of <br /> the improvement or other right-of-way use hereto applied for and fuAher agrees <br /> � -�,� � to remove same upon notice from the City and to replace public property <br /> '-_�.-'� �'- f�_ �7 da thereby. <br /> FINAL INSPECTION Date <br /> Approved as Constructed <br /> — Sig ture of pplica Date <br /> WORK AUTHOF,ZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS TO BE DILIGENTLY PURS ED TO <br /> COMPLETION.THIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />