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, � <br /> Date � �--�Q� P�„�,��•�o,..PP,�.,,�: �l`�1 __ <br /> ApPIic2�ionFor TO P�STING�� �oo���..��j��.���s___- <br /> � PUBL.IC WORKS PERMIT P°°°°W°��=F°�s - <br /> ti✓p�r,�� ,��:,�F�.�• — <br /> l•1>y Lui.Fppl Fr.c PaiU S <br /> �D��: �,,�����o�� 5 ZD. -- <br /> 9 y� Print or Type Only -- <br /> H >�3 �,y� <br /> `� Hz —li�[�EfLCi—�Cl� —/Yr �`�yk �� .CiNr,y��E �/,sf�r�j C��, � —�o��� <br /> � H O Ov+ner Mailiny Address Cdy Lip Phone <br /> [p F� <br /> z SR�e� <br /> � y� Apphcant Mailin9 Atldress C�t/ Zip ?hone <br /> '" "�" �1A' t <br /> �, <br /> H �� Ccscribe ProPosed VJorh _ �!{�� L�iy,•i�i R/y(11�—r_�L�C �� � G � I�y�1'1P..�, <br /> �V n � / 1 <br /> z9y� — <br /> r H y -- — — -- � <br /> � <br /> H <br /> � �r Projec�Adtlress Iil known� _ � I� �5 t{" ,r_` -- _ � <br /> � Ai�ach four 14)coples of plons lor proposatl work- ir,�:•. In rub�:�nc1 nolc Inc'ollo•.ving as applicable�. � � <br /> z y�n <br /> y O V1 • Proi '-rty Lines • Centerlme of s�reet ♦^ <br /> • Outi.ne and diioensions of all e*�sa�,y ;,ncl • Ind�cate Norlii V� <br /> proposeA sirur,tures on�he lot • Show any prOposCtl yr:itlinn -hanqes <br /> 3 =xisting and proposed ut;iiGes • Show mcasuremenls � � <br /> DO NOT IVRIiH BFLOV!iHIS LINE �� <br /> PERMIT CONDITIONS O <br /> ',` �� 1.All calls lor mspEction shall he matle 24 hrs.in advance�p'ione 259•8810. � <br /> 2.All wcrk shall be peAormetl in accorAance with this permit and r.urrent Gty of Evere;! Des�gr and Consiruction <br /> iO��"'' S�and'ords and Specilications. <br /> 3.Call Locat�: �.�derground Service 48 hrs.before you dig.TOII FREE NUMBER 1•8J0•424•5555. � <br /> ,.. � 4 . Inatal l rock construction entrance hehind cL•�iveway :�s <br /> ` ,� pei• city ai:andaro #2�_, to eliminate tracking mud oni:o O <br /> r�treets as directed by Public Works Inspector. <br /> 5. Keep city streeT,s clean at a1�L t.imee. <br /> ii. CurU, gutter �,nd eidewalk in the plat are new �nd � <br /> '�` �► und.smaged, any damage thereto Nhall Ue repl.aced at the <br /> discretiun of the Public Works Inepector. r^ <br /> 7 . Any change in the driveway cut must Ue approved L�y the ��� <br /> ,� h PuUlic Worlta Inspector. � <br /> 8. TightJ.ine all rocf, yard and driv�way drains from <br /> hoi�ee� t�: U.A. ytubr� aY, back of aide w=illc •�riLh ruUi�c^ a <br /> gaa}teY. F. V.C. pipe <br /> `�^ � 9. Adjuat water boxes to grade at and of conatri�ction. <br /> `y � ?0. Dr:vewa,ya �hnlJ be complete]y cured before criving on <br /> �"" �' i� �j� "�1e11�' ACKNOWL[f70[M[NTOFCONDITIONS <br /> �°" '+ (�_�r''��,� _ The undursi�7ned ownrvi/:�UP'��c:ml hrreby a�rees to hold anA sav0 hainr <br /> . Iess Ihe Cily ol cve.etl Imm any and all claims for damapes, cos(s, <br /> expenses. o� causes ol action ihat may :r;e because of installation <br /> ., �__ f7 ,r�n ��� z � L I` r�� anA ^iaintenancr. o� Ihe improvement or o�her ri9hPof-way use hereto <br /> (,v_t..t.X_. �Y t __ applied �:� ard h�.iher agrees lo �emove same� uFon nolice Irom ihe <br /> Approvedlor ConsVuction Date City an.: � . .�,pince pubi�c PropeitY���inaqud Iliereby. <br /> // �� ', / <br /> // r.= / <br /> � " � //i� �..�� f�/% � /% � Y�j <br /> —�—�-c�..--'- t C" ' <br /> FI AL�IN NSPEGTION � G � � Daie � <br /> Appwved as Constructed Si9nainre of Apphcanl Da1e <br /> WONK AiITHURIZED 6Y iHIS PEF"IT MUST BE START[D WITHIN <br /> everetl PU3LICVJORKSUEPAFlTMtNT 1II0 DAYS OF DATE PEFMIT IS � JED AND THEREAFTER IS TO <br /> � 3200CedarSireet BF DIIJGEM�LY PURoUEV TO COMPLETION. 7HIS PERMIT MAY BE <br /> EveretL N'A o8201 CANCELL[��Y THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone�.259�Bt3t0 pHOJLCI OVER 90 UAYS DUFATION. <br />