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i' <br /> ��1 ///�..,,��l ��/��,� Puuhc WorMs Pcrmit� �LI "----- <br /> DateJ�r�S�[�1 <br /> � � Application For TO POSTING��` / �t � ��°" o�o� a ��Z 'S�4____-- <br /> II PUE.3l..lC WORKS RERMIT '°°'"`YOtSFO --- -- <br /> �C� ,o�,,�F�e s <br />�� [� Less ApG.Fax Pai� $ <br /> !��a <br /> .��,n x �alance oue S� <br /> 9�y Print or Type Only <br /> y �Z H �J'rG3 <br /> " y z ��n�e.rr� �9 ��/ - /11 �y�7ry .S`l- Sc�n tf�P � S�l�— ,f;t� ;' <br /> � H� Owner —�� Maili.�y Address City 7ip P'ion� <br /> fn H <br /> E� z c'� �`��'- -- — <br /> � ApPiicant I.tailmg Addn+ss C��y Zip Phone <br /> H C7 <br /> [,�j�� Describe Pruposed V/ork ��t_--aL.L1Cd��—�-p-t111.J1�}--1-�5-�(,(-f�l�� `�d� % �G T�I !iL_ �V _ <br /> H � J <br /> a �� -- ----- � <br /> r z _ <br /> r+H � <br /> N <br /> N <br /> n d�n --- — ��`!:� ZS+h 7r .� � <br /> � �� Project Address Id knownl _ -- -- ---- <br /> 2 y A� Aur,r.h lour 14) copies of plans br proposed vmrk� Dra-v to s�::ilc and nole��e �oilowing as anui�:�„i'�ic �� <br /> y �� • Property Lines • Cenlerline o� '�"� ��! ♦^ <br /> � • Ou�line and dimensions o�all exisiing anA 4 Ir,dicate Nort� y♦ <br /> prOP�sed slrw'�ure5 on ,h�, Ioi • �hrnv any n���; . .,rl �irurl�nq chunooti <br /> • Exis�ing and propo5�d utJtlies • Shb:� mcasuraim�rls � <br /> � DO NOT L'JRIiE B[L0�7 THIS LINE: <br /> PERMIT CONDITIONS � <br /> '� .� 1.All calls for inspection shall b���:nade 24 hrs.�n advance-phone 259•8S1 O. � <br /> .m� 2.All w•ork Shall oe pedormed ir�.accordance�.ith ihis permit and curtent Cdy ol Everett Design and Construction <br /> St�ndards and SGeahcatiom;. <br /> 3.Ca!I Location Under9round Scrvice 48 � b=1or2 you dig TOLL FREF NUMBER 1-800•424•5555. � <br /> �"'�� 4 . Instnl] ;ock constructi.on entrance behind drivew,sy aa <br /> � .i per city :3Y,andard ii208 to eliminate tracking mud onto O <br /> streets aa directed by Public Works Int�pector. <br /> 5. Kcep rit:y s`.reeY.s clean at all Y.imes. <br /> � � 6. Curb, �utter and sidewalk in the plat aie new and �� <br /> undama6ed, anv damage thereto sha]1 be replaced at the ,. � <br /> discretion of the Public Work9 In�FPctor. ��7 <br /> '� � 7. AnY change in the driveway cut must be appruved b,y the Q <br /> � � PuUl:i.c Works TnepecY.or. <br /> 8. Ti.gh1•line all roof, yard and dr.iveway drains from � <br /> houses to C.B. stubs at back of sidP walk with rubber <br /> �i � eaekeL- P.V.C. pipe <br /> 9. Adjust: water bexes Y.o grade at end of construction. <br /> 10. Driveway� ah�.l.l be completely cured Uefore driving on <br /> 'r i;}]em. ACKNOWLEDGEMENT Of�pNDIT10N5 <br /> a� � �'(�` <br /> �; �?.� � __ The untle�signed owner/applican�hi�reby a�i�es Io hold and save harnr <br /> — — — less �he C.ly ol [verett irom any and all claiins for dama9es, costs, <br /> ezn�'�����. or causes ol .iction ihat may arise because ol insinllalion <br /> .� �- p anU maintenance of �he impre �menl or o�her n[�h4obwaY �>>�� ���'�r.lo <br /> �-✓.. �Y-.QR_ � —l1^9 � ❑PPhed br and fwthcr a9!ecs te . ��o�e same uP�n nolice irom ihe <br /> ApprovCd f�, Construction ��a��' C�ty and lo rePlace puhLc propert� �,.�:.i�ged thereby. <br /> � r <br /> ��^, i <br /> /�, , ,f%,�,-r,-_�,� i, ,� -:,--- `v -_=� � � <br /> FINAIINSP[CfiON � �'3�e � �--� �� � <br /> Approved as Cons�rucl�d Sonaiure ol Apphcant � ��'�Q <br /> NlORK AUTIIURI2ED BY TIiIS PERMI�� MUST BF STARTED "'ITHIPI ' <br /> everett PUBLICWORKSD°PARTMENT 1g0 DAY� OF DATE PERMIT IS ISSUED AND THEREAFTf .S TO � <br /> � 3200CedarStme� BE UIUGENTLY PUHSUED 70 COMPLETION. (HI:' PERMIT MA� BE i <br /> Everett,VaH 98201 CANCELLED BY idE CIT�UPON ANY STOPPAGE OF WORK Ot: i HIS <br /> Phone:259-8810 pNOJ[CT��VCH 9G DFYS UURATION. <br /> I <br /> y' <br /> 1 <br /> � <br /> 1 <br />