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Date 6/8/93 C/ _�� /� s r�cuowo�k.va,mu. �3 Z� / <br /> eie9 oec�.•. 40863 <br /> Application For <br /> PUBLIC WORKS PERMIT GuElicWarkeFee , <br /> ` To'al Fen <br /> TO POSTING - � � - <br /> Less Appl Fee PaiO S �� <br /> B�lanee Dua S <br /> Print or Type Unly <br /> Douglas Kyllo 22629 53rd Ave SE Bothell WA 98021 485-3827 <br /> ' Owner Mai{ing Address City Zip Phone � <br /> Same <br /> . Applicant M:. -�Address City Zip Phone <br /> New house - Basic 219 <br /> � Describe Proposed Work <br /> W <br /> Project Address(if known) 'b1 ('1 ' 21W�, �L � ~ . <br /> � Atlach four(4)copies of Plans far proposed work• Draw to scale and note the following as applicable: � <br /> � • Property Lines • Cenledine ot street � <br /> � � • Outline and dimensions of all existing and • Indicate North <br /> ��.. proposed structures on the lot • Show any proposed grading changes <br /> � • Existing and proposed utilities • Show measurements M <br /> W <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS � <br /> � 1.All calis tor inapectbn ahell be made 24 hrs.in advance•phone 259-8810. <br /> , 2.All work ehall be pertormed in accordance with thie parmit and current City of Everett Design end Construction <br /> � Standerds and Specificationa. � <br /> 3.Call Location Underground Service 48 hrs.betore you dig.TOLL FFIEE NUMBER 1-800�4245555. <br /> 4. Instsll rock construction entrance behind driveciay as Per city O <br /> standard #208 and eroaion control as directed by Public Worke <br /> Inapector. <br /> 5. Keep city atreets clean at all times � <br /> B. (�rb gutter and aide�alk in the plat are neH and undama6ed, <br /> • eny damage thereto ahall be replaced at the diacretion of the � <br /> Public Worka Inepector_ O <br /> 7_ Any change in the driveway cut muet be approved by the PW In- <br /> ` spector, width at prop line limited to existing apron width. � <br /> ` g. Connect all roof, yard and driveWay draine to storm drain <br /> , syatem provided to lot. <br />� S; j t g. Ad3ust water boxea to grade at end of construction. <br /> 10. Drive�aYs ahall be completely cured hefore driving on them_ <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicanl hereby agrees to hold and save cosis, <br /> �� less ihe City of Everell (rom any and all claims for dameges, <br /> � � I! �� ezpenses, or causes of action that may arise because of installation <br /> 1f� and mainlenance ot lhe improvement or other righl•oFway use hereto <br /> � applied for and furiher agrees to remove same upon notice irom the <br /> Aporoved tor Construction Date pi�y id to replace public properly damaged thereby. <br /> � �p���� � <br /> G -� -"a <br /> N L INSPECTI Date Dete <br /> Approved as Constructed gnatu f Applican <br /> WORK HORIZED HIS PERMIT MUST BE STARTED WITHIN <br /> � PUBLICWORKSDePARTMENT 780 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200CedarStreet BE DILIGENTLY PURSUED TO COMPLET!ON.THIS PERMIT MAY BE <br /> � Eve•e:t,WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON TH�S <br /> � Phone:259-8810 PROJECT OVER 90 DAYS DURATION. <br />