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T�rc \ <br /> �� <br /> Date 2'25-94 =u + <br /> ' +� � ' ,.�,�7.�,��4 I Puplic WprNa Permi�r � <br /> Application For �� ema.oea�.• �:3¢' 8 <br /> PUBLIC WORKS �ERIpIPASTING a-� bl¢WorkSRo -- <br /> � raiai Fae s_ __ <br /> � LessAool.Fee Paia ��^ <br /> Print or Type Only � 0 4 g g �o g � $ � O Belanca Due s __ <br /> N t? U100 �Ftl In Ifj p �y' (� \ <br /> t% p? O .�i ri bl C.1 d' C� f� Cul �l / <br /> CJ .~-tNN W dl bt w +p � � /— ' <br /> ��� <br /> Countrywood Homes 14410 Bel 11ed �dFI1200 Bellev " WAo 98007"' 644-2323 �-� <br /> Owner Mai4ingAddreac� r? �it x <br /> � ,�r � -Y �, � � � � ��P, Phone <br /> � oo � � o u�5 � .�. o � $ � r �' <br /> Onwer � $ t� a''. i �:', mo � ag �em `•+ �, <br /> Applicant Mailing Atldress Ciry Zip Phone � <br /> � <br /> Describe Proposed Work new hou�e • ' � � <br /> Lot 11 Powder Mill Div 2 (`� <br /> ' S808 25th Ave W ✓ � <br /> Project Address(if known) � <br /> 4ttach four(4) copies of plans for proposed work• Draw to scale and note the following as applicable: <br /> � <br /> • Property Lines • Centerline of street � <br /> • Outline Tnd dimensions of all existing and • Indicate North �� <br /> proposed structures on the lot • Show any p�oposed grading changes <br /> • Existing and proposed utilities • Show measurements � <br /> DO NOT WRITE BELOW THIS LINE � �I <br /> PERMIT CONDITIONS O <br /> 1.All calls for inspection sh:all be made 24 hrs.in advance•phone 258•8810. <br /> 2.All work shall be peAarmed in accordance with this permit and current City of Everett Design and Construction � <br />� Standards and Specifications. <br /> 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER�1•800-424•5555. <br /> 4. Instal rock construcNon entrance behind driveway as per ciry Z <br />, standard tR208 and erocion corHrol as dirocted by Pubic Warics O <br /> Inspector. <br /> 5. Keep city streets cban at al times <br /> 8. Curt gutter and sidsvak in the pfat ars new a�d undamaged, � <br /> arry damage thereto shal be repiaced at the discretion oi the <br /> PubYc Works Inspector. � <br /> 7.Any change in the driveway cut must be approved by the PW In- <br /> specfor,width at prop ine imited to existing apron width. O <br /> 8. Connect al root,y�rd and drh+eway drains to stortn drain <br /> system provided to lot. � <br /> 9.AdJust water boxes to grade at end of construction. <br /> 10. Drivevpys shal be compktey cured belore driWng on them. <br /> �` ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm• <br /> /� less the City of Everett from any and all claims for damages, costs, <br /> ) /� ^' ,//AG� � _�—�� expenses, or causes of action that may arise because of installation <br /> . <br /> �� �� /`! and maintenance of the improvement or other right•of•way use hereto <br /> Approved for Construction �pplied for and further ag�ees to remove same upon notice from the <br /> Date City and to replace public property damaged thereby. <br /> ���? 5'-/G • . <br /> FINALINSPECTION � C/'h'-- � �jQ�l� Gy�.u-y� .3/IG f 94 <br /> Approved as Constructed Sigrature of pplicant Date <br /> �A�� PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200CedarStieet 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett,WA982G7 i BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone:259-8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJEGT OVER 90 DAYS DURATION. <br />