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,�..�,,,. . _ ___._ . <br /> - <br /> �y� <br /> / <br /> Date�—S—Q� - PublicWodsPoemil+ ���_ <br /> Application For TO POSTING �'1�' .�] '7.J Biag.oeo�.• 35844 <br /> PUBLIC WORKS PERMIT PublicWork3Fae <br /> Toial Fee S <br /> ' less AO�L Fee PaiE $ <br /> Print or Type Only ` ` , ` ' ea����eo�e s ZO— <br /> � <br /> - f., _ _ <br /> i ; <br /> Countrywood Homes 14410 Bel Red �Rd. 11200 Belleuve WA 98007 644-2323 x142 �� <br /> Owner � � ' "Aailing Address , . . City Zip Ph�ne 1 <br /> ,., ,, � , ; � N� <br /> , - , � , � , . ,;; Angie Stevens <br /> � � ; , , � , �,,� N� <br /> �wr.er � � : , ,. �.,, - �`s <br /> Applicant Mailing Address City Zip Phone _, <br /> DescribeProposedWork SFR Lot 22 ����E�2_ N�ILL <br /> W <br /> ProjectAddress(ifknown) _ 593Z — 25TH {a�/�E V� � <br /> Attach four(4) copies cf plans for proposed work- D�aw to scale and note the following as applicable: � <br /> • Property Lines • Centerline ol street � <br /> • Outline and dimensions of all existing and • Indicate North <br /> proposed structures on the !ot � Show any proposed grading changes <br /> • Existing and proposed utilities • Show measuremenis � <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1.All calls for inspection shall be made 24 hrs.in advance•phone 259-8810. � <br /> 2.All work shall be performed in a�cordance with this permit and current City of Evereti Design and Consiruction <br /> Standards and Specitications. <br /> 3.Call Location Underground Service 48 hrs.before yo�dig.TOLL FREE NUMBER 1•800•424•5555. � <br /> 4. Install rock construction entrance hehind driveway as per r.i.tY <br /> standarri #208 and erosion .r,ontrol as directed b7! Public Works o <br /> Insp�r.t,nr. <br /> 5_ Ke�p r.itY streets clean at al: times <br /> 6. Curb �uY.ter and sidewalk i.n the plat are new and undamagPd, � <br /> any damage thereto ��hal] be replaced at the di.scretion of the � <br /> Public Wnrks Inspertor. <br /> 7 . Any chat�ge in the dri.vewaY cut must he aFproved hv th�: PW In- O <br /> spector, wi.dth at prop li.ne limi.ted to existing apron wi.dth. <br /> 8. Connc-ci; al.l. roo£, vard and dri_vewav drains to storm drai.n � <br /> �ys.*,em �r•ovirler3 to lot . <br /> ? . Ad,iust water boxes to �rade at end of r_onstruction. <br /> ]0. Uriveways shall i�e r_omPletelv r_ured before dri.ving on them. <br /> �r71.�. ACKNOWLEDGEMENT OF CONDITIONS <br /> �'lJ <br /> The undersigned o•.vner/applicant hereby agrees to hold and save harm- <br /> less Ihe City of Everett from any and all claims tor damages, costs, <br /> expenses, or causes of action that may arise because of installation <br /> � � f1.,1 G�CR� � ,�7��,9 and maintenance of the improvement or other right-ohway use hereto <br /> I � < <� pplied for and further agrees to remove same upon notice from the <br /> Approved for Cor�truction, Date City and to replace public property damaged ihereby. <br /> !/ � , <br /> � <br /> � l �-✓•i3 /� �/ �� <br /> FINAL INSPECTION Date C ` -' . - ` � �� <br /> Approved as Constructed Signature of Applicant � Date <br /> PUBLIC WORKSDEPARTMENT WORK AUTHORIZED BY THIS PERMIT M ST BE TARTED WITHIN <br /> �A�'� 3200CedarStree. 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett,WA 98201 ' BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Phone:259-8810 CANCELLED BY THE CITY UPON AfVY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. � <br />