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<br /> Date �r�s -° 1 /��c.jd�--
<br /> Fim9 DeN s— _ —
<br />�I � �.-, Fpphcation For . _ _
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<br /> ��� PUE�LlC WORKS PERMI�' P°°'"°'°""`` 5
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<br /> '�1 H'�J Owner � r.a r�MaiAn9's3 6e6s i • �ily Zip
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<br /> c��i�'g AIa;A� � ! ��u1y- r_e��i�e1L���—�,�a�l.t,'e '1 /�
<br /> qqg Describe Proposed Work _»���' —
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<br /> �� Prolec�Address lif Fi..s:+nl _- �13 — 2S �� � SC ----
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<br /> y p� Atiach four ld) -oples of Plans lor proposen work- Dr.uv to scale anA nnlc ILe lolloviing as apphcabb• �
<br /> • Proper�y Linea • Cenirdine of sireet
<br /> • Ouiline and d�„•en5ion5 0l ali exi5iin9 d�n��
<br /> • Indir,ate Nonh
<br /> propo5ed S�n_ ::es on Ihe i,�t • ShoW nns proposetl i)r�d�.�y U�an�us
<br /> O Ex,s�ing and VwPos�:d ut:hhn,�. • Sho�v mc:i5ure�ucnis �
<br /> DO NOT�VHI7E BELONJ TfIIS LWF O
<br /> r, + PEFMIT GONDITIONS � I
<br /> � ' 1.All calls fur inspectio.,shail be ma�e 24'•�s.,n advancc�phone 259•8810.
<br /> ""� 2.All v;ork shall be penormed in accordance w�'h this permit and wnent City al Everett Design and Construction
<br /> Standards and Specdications �
<br /> � _ 3.Cal�Location Underground aervice n8 hrs.heforc y�d di9.TOLL FRE:E .:U"hBER 1•B00•424•5555.
<br /> ( � q. Install rocl: consY,:�+ction entranee behind driveway as
<br /> p^r city staudard Si208 to eliu.:nate trackin5 mud onto O
<br /> sY.reets as directe,rj bv F'ublic W�rka In�pector.
<br /> 5. Keep citY streets clean at til �. times. �
<br /> .�. ,,,� G. Curb, �utter and aidewalk in T.he Plat are new and
<br /> undamaged, anY damaga ther^to ahall. Ue replaced at Lhe �
<br /> discr�tion nf the Pub] ic Wcn'ka Inspector.
<br /> 7 . An,y change in the drivewa�• cut musc . � approved by the
<br /> "" '"" F'ublic Warkr Inspector. O
<br /> g_ �'� g}�Ll ine a] 1 roof, yard and drivecray drains from �
<br /> houaes to C.B. atubs at back of. siac walk with ruUbec
<br /> 0 E y gasket P.V.C. pi.pe
<br /> g, Ad,iust water bnxea to �rade aY,cered�beforatdriving u:i
<br /> '/ lp. Dr.ivewav3 sha] 1 be comAl�te]y
<br /> '�`'�' t I t;]7eti1. qCKNOWLEDG[M[NT OF CONL'�I',IONS
<br /> –� .� ��k
<br /> f. 1�'��/( _ _ The undcrsgnad owner/apPlicinl here6y a9�e�?s to huld and eave hnrm-
<br /> _ — Iess Ihe City of Everelt irom any and all claims for Aama9rs, c.s�s.
<br /> expenses. o� causes of aclion Ihat may an%e because of installation
<br /> • �r�-�`� �_ ��9�— and rna�ntenance ol Ihu improvement or other ri.JhPnFway usa here�o
<br /> _ npphi�d for and �ur�her a9rees �o rem���e same upon nohce from tlie
<br /> 4pprove�.lor Consiruclion D��IE Cdy;md toJ�/F�+ce Puhhc proPerty dama9ed ihereby.
<br /> �i . - � / , / `.
<br /> -5>'�. , �i`^ ,"!'��'_� G� /,,/T/ '����� /,J�� L ���,
<br /> FINAL INSPECTION�� � ' Date Date
<br /> 4pproved as Conslruc�ed 9naWre o�Appli�anl
<br /> WOHK AUTHOfiIZED 6Y THIS PERMIT MUST BE STAflTED WITHIPI
<br /> �.«��� PU9LIC WORKSDEPAFTPAENT p0 DAVS OF DATE PER6�1T IS ISSUEO AVD THEREAFTER IS TO
<br /> I� 3200Cedar5lreet �E DII.IGENTLY PURSUED 10 COMPLEiION. THIS PERMIT MAY BE
<br /> Everelt.WA98201 CANCELLED BY THE CITV UPON ANY STOPPAGE OF WORK ON THIS
<br /> Phonc:259�t3d10 PROJECT OVER 90 DAYS DURATION.
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