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�� .. <br />� <br /> , <br /> �a�e 6/8/93 �j ' 2���� S Pu01ic Worke Per:n�a q� �/ <br /> Applicetion For� <br /> TO P�STING�.l� 't ' B�'° °", . <br /> PUBLIC WORKS PEPMiT Pub7ataFeeFee s _ <br /> Leef R00�Fee PeiA � <br /> �. � � Ba!ante Due S�� <br /> Print or Type Only <br /> i ,, . Dou las K ll0 22629 53rd Ave SE Bothell 98021 485-3827 <br /> i � '� � . Owner MaiNng Atldress Ciry Zip Phone <br /> I� � ' � � ' , � . . � . <br />� Same _ _ <br /> I - �, Applicanl Mailing Address City Zip Phone <br /> New houee – Basic 219 <br /> � � ' ' Descdbe Proposed Work — <br /> � . I _ <br /> 4 t ; – --'-- <br /> ��� � 1 — --'._. <br />� � � W <br /> , , : <br /> � 1D1Z3 �+� /-�' Lot 21 Eisenhower Ct � <br />� ' ` - , Prolect Address(if know��` <br /> � <br /> ��! I. -` <br /> Attach tour(4)r,opies ot plens for proposr,d work• Draw to scale and note Ihe tollowing as applicable: � <br />�s � �� � • Preperty Unes • Centerline of streef � <br /> f j'ss, � • Outline and dimensiona �I all ezisting and I� :idicate N�.�th <br /> � � � proposed structures on the lot • Show any proposed gradin�i changes <br />� ��1� ' • Ex�sting and proposed utilities � Show measurements M <br /> 1 , W <br />� ��+ � � DO NOT WRITE BELOW THIS LINE � <br /> E����,.�� I <br /> . � ..: , i <br /> PERMIT GONDITIONS � <br /> 1,qll calle hx insnectlon shall be mac'e 24 hrs.in edvence•phona 259•8810. <br />' 2.All work s1;a!I be pedormed in accordence with this permit end wvent Ciry of Everett Cesign and Conatruction <br /> Standerda and Specfficatlona � <br /> ' 3.Call Lxation Underground Service 48 hra before you dlg.TOLL FREE NUMBEN 1•800�4245$$5. <br /> 4. Inatnll rxk conatruction entrance behind driveway as Per city O <br /> atandard it208 and eroeion control as directed by Public Works <br /> Inapector. <br />' 5. Keep city etreets clean at all timea � <br /> 8_ �rb gutter end sicleWalk iri the plat are new and undemaged, <br /> any damage thereto shall be replaced at the discretion of the � <br /> Public Worka Inapector_ <br /> 7. Any chan8e in the driveway cut must be apprwed by the PW In- O <br /> spector, Width at prop line limited to existing apron width_ <br /> 8. Connect all mof, yard and driveway draine to stnrm drain /� <br /> system prwided to lot. �i <br /> 9. Ad,iust water boxea to grade at end of conatruction_ <br /> 10_ DriveHaye ehall be completely cured before driving on them. <br />'r,��`�4 � � � ACKNOWLEDGEMENTOFCONDITIONS <br /> � n� The undersigned owner/applicant hereby agrees to hold and save harm- <br />` �� � lJ< << '�� •—� less the Ciry of Everett from any and ull claims for damages, wsts, <br /> i��� , � r � � expenses, or causes of action that may arise because of installation <br /> ������ � _ _— and maintenance of ihe improvement or olher right-ohway use hereto <br /> Cv�^G applied for and furthar agrees to remove same upon notice from the <br /> Approved f onstruct' n Date City a to replace public property damaged thereby. <br /> ��j�.Go /.��/� <br /> p1 � I PERTI N Date � Date <br /> n ure of icant <br /> Approved as(.onslructed WORK AUT O IZED BY TNI ERMIT MUST BE STARTED WITHIN <br /> PUBLIC WORKS DEPARTMENT 180 DAYS O DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200CedarStreet BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Everett,WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259-8810 PROJECT OVER 90 DAYS DURATION. <br />