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_ _ _. .-�_ <br /> 1-23=95 y� <br /> Date M ;�Z -2�-'� <br /> L `-' <br /> Application ForTQ POSTING .� -� 9� `"°'""'°`"'P°`m"' ��- <br /> eiaq 000�.•_ 46792 <br /> �''UBLIC WORKS PERMIT P PublicWo�ksFBe -- <br /> � Tolal Fee S <br /> cL ._ <br /> � Less ApPI Fee PaiE s <br /> Print or Type Only � — <br /> � �� O O L'1 Bal�e Du� � �_�f,� <br /> L r. nonln <br /> � [- �t C� U 'Y O IO O O f_t <br /> I(� C.J 0] 0.l N +R- C'! 0 l� Q CI <br /> �� �. f� If} f14 b3 i iJl' `15 (�" <br /> Countr ood Homes 14410 Bel Red Rd �l?.00 Bellev°e 98007 644- 23a � '� <br /> Owner Mailing qtldress <br /> .� <br /> � � c� co x cv i � o w o � o "�—'P'hone �,^\' <br /> Owner " �' � � r� c� r� FaoF- oarnw <br /> � o _� _� w _� :� r< o a ow -- x �•a1 <br /> CJ a fi? ��_ 3_ fil ftI L't 3C 3 ZC ul N [_t <br /> Applicant Mailing Address �i�Y — Z. f <br /> P Phone <br /> Describe Proposed Work neW house <br /> �ProiectAddress�itknuwn� 5830 25th Ave W Lot 9 Powder Mill Hi hlands II <br /> Attach four(4) copies uf plans for pioposed work- Draw to c,-31e and note �he following as applicable: H <br /> • Property Lines • Centerline of streot — <br /> • Outline and dimensions of all existing and • Indicate North � <br /> proposed structures on the lot • Show an <br /> • Existing and proposed utilities Y proposed grading cha.�ges <br /> � Show measurements <br /> C NOT WRITE BELOW THIFi LINE � <br /> PER�.AIT CONDITIONS O <br /> 1.All calls for inspection shall be made 24 hrs.in advar ce-p!.one 259-8810. � <br /> 2.All work shall be peAormed in acwrdance 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•$00•QQ4•5555. <br /> 4. lnsiall rock conshuction r.nUvice bef�ind ciriveway as per city staudarA k20g .._d erosiou control as directed bv � <br /> Fu�;ac Work� L�spzcto�. O <br /> 5. F_eep r'ty streets clean at aIi fimes. <br /> ::. Cwb gutter and st�ewalk in the plat are new a��d imdamaee�' ��ty damage tl�ereto shall be replaced at die <br /> discrelioa oFUic PubGc Works Lispcctar. � <br /> �. Arty change in the drivew;m cut mnst be apprnved by the PW inspectnr, width at pmp line limited to e:tisting <br /> aprou widlli. � <br /> 3. Adjust water bcxes to ;�;ide at end of constniction O <br /> 9. b�rveways shall be completely cured betore cinvine ou Wem. <br /> l0. Fooftop �4;iivage shull Lc clisch��ed: � <br /> . lo U�e site's stom� drain system (private or public) <br /> . to a residenpal roof��lownspuu,sy�tem desie��ed per secdon 4-9A of tlie ciry standards <br /> . onlo splash blocks <br /> � The methad selected wi11 he snbject to Fuhlic Works i)epartement apPNrop;11LEDGEMENT OF CONDITIONS <br /> ��1^ The undersignedowner/aPPlicant hereby agrees to hold end save harm� <br /> � '�' – less the City of Everetl Irom any and all claims for damac�es, costc, <br /> �' � /N/A/ i� exPenses, or causes of action that may aiise because of installation <br /> �;� �� '' ` � �� �' and maintenance of the improvanent or other right•of-way use hereto <br /> ��C% <br /> Approved for Construct�on Dale applied for and further agrees lo remove samc upon notice fro:. the <br /> �" City and to replace npublic property damaged fhereby. <br /> `� /-// c: ' � - / <br /> FINAL INSPECTION � G � `� <br /> ApprovedasConstructed ��1e ��'� � �t���v ��/�� � <br /> ��r„� Signature ol Applicant ':�i,e <br /> � PUBLICN'ORKSDEPARTMEN; WORK AUTHORIZED BY TF'IS PERMIT MUST BE STARTE�� lYl'HIN <br /> � 3200CedarStreet 1B0 D.4YS OF DATE PERMIT IS ISSUED AND THEREAFTCR I� TO <br /> Everett,WAgb207 BE DILIGEN'.LY PURSUED TO COMPLETION. THIS PERMIT MqY gE <br /> Phone:259�8610 CANCELI ED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJEi,T OVER 90 DAYS DURATION. <br />