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Application For /� <br /> PUBLIC WORKS PERMIT �ate 3/26/96 _ <br /> /POSTI NG rw , 9 ��UBLIC WORKS DEPARTMENT Public Works Permit k ���.Z_.g__- <br /> 3200 Cedar Street <br /> Everetl,WA 98201 259-8810 yuilding Permit fl 51�1 S <br /> ^� � <br /> IYPE OR PRINT ONLY Public Works Fee$ <br /> COUNTRYWOOD HOMES 14410 BEL—RED RD BELLEVUF. 98007 649-8159 <br /> Owner MailingAddress City Zip Phone ,� <br /> \ �` , <br /> � <br /> Appllcant Mailing Address City Zip Phone <br /> Describe Proposed Work NEW HOUSE — II4SIC 1178 __ . � ■ <br /> W <br /> -- F"' <br /> � <br /> � <br /> PROJECT ADDRESS(ifknown) 5432 25TH AVE W LOT 56 POWDERMILL DIV II <br /> Atlach four(A)copies of plans for proposed work-Draw to scale and note ihe following if applicable: �►��6 z�3� ��R� �k�� <br /> •Property Lines 'Outline and dimensions ot all existin9 and proposed structures on the lot •Existing and pronased�iuUes O <br /> IRMA1L19 <br /> •Centerline of street •Indicate North •Show any proposed grading changes •Show measurements �� s1�60.5� ' <br /> DO NOT WRITE BELOW THIS LINE ' <br /> PERMIT CONDITIONS: � �'� Z <br /> 1. All calls for inspection shall be made 24 hours in advance- phone 259-8810. � �•� <br /> 2.All work shall be performed in accordance with this permit and current City of L�'Desi�� O <br /> Construction Standards and Specifications. II0�71 <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUM�800�5. � <br /> N00030569 <br /> SEHER f70.00 � <br /> S4�3DEV f600.00 O <br /> d. Keep city streets cle�n at all tirnes. p{Eq( �p3g,pp <br /> ,. Cwb gutier:uid sidc�v;ilk ui thr plat :ue i1CR':u�d w�d�nageJ. :my dmuage Werrlu shall bz rrplac�J al II � <br /> discrcfion of the Fublic \�orks Inspcclor. <br /> 6. rim change in the cltiveway cut must be �pproved b.�the YW h�spector, width at prop line Imtited to <br /> axisting apron widlli. � <br /> �. Adjust water boxes to grade at end of r,onstn�cdon. <br /> 3. llrivoways shal!be wmptetety cured before ciri�ing on Uicm. <br /> 9. RooRop dramage shall be discharged: <br /> • to the sitc's storm drain s��stem (private or pubGc) <br /> � to a resiJoufi:il roof downspout syslem desi�ied per section 4-9A of the city sfm�darJs <br /> • onto splash blocks <br /> Che method selected will be subject ro PubGc Works Inspector approv�l. <br /> �� ACKNOWLEDGEMENT OF CONDITIONS <br /> � �� The undersigned ownedapplicant hereby agrees to hcid and save harmless <br /> the City of Everett trom any and all claims tor damages.costs,expenses,or <br /> rove for nstrucY p � causes oi action that may anse because of installation and maintenance oi <br /> AP the improvement or other righhof-way use hereto applied for and further agrees <br /> �:� to remove same upon notice from the City and to replace public property <br /> � � � � �� �� �� dam ed thereb . <br /> INAL INSPECTION Date � �` <br /> Approved as Constmcted `� <br /> v <br /> Sig t A pli ant Dete <br /> WORK AUTHORIIED BY THIS PERMIT MUST BE STARTED WITHIN 780 DAYS OF DATE PERMIT IS ISSUED AN EREAFfER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLETION.THIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />