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l <br />� <br /> I <br /> i <br />�� :� �_7O_Zg_ S /' - <br /> 1/11/�4 yi. P��CImWorksPormlt4,� � GI`-'' <br /> Date 91dg OeO� • <br />` Application FPr <br /> I pUBLIC V�/OR� �'E�M�T P����cWa�ksFee 3 <br /> Total Fee <br /> o '�� NaSTlNG �' � ~�� LestPOPI FeePaiJ �—� <br /> Balance Due ' L� <br /> Print or Type Only � $ �' � � � � � g � � � <br /> �- ,o � o ci .r o vi u� o o .e <br /> N Npp � .-' N CJI'? M ,y � � <br /> � �p �p yT M M <br /> Oak Crest Homes 13712 64th�r SE Snohomis 9 90 "� Z37-1229 phone <br /> Owner Mailinc,�4tidros � � � � <br /> C� � �g <br /> cp G] V�yI OJ �S5�+ 2Jopia– S t� <br /> � 3 C � C�i S O7 Cil O 6. i F 3 �t ti �.] <br /> Same � — Phone <br /> ----- Mailing Address City Zip <br /> Applicant <br /> New house - Basic 240 <br /> Describe Proposed Work _ <br /> - - W <br /> I �I Z-� � Z(� Q1/e SG Lot 22_Eisenhower� GEtT(� � <br /> Project Address(if known) _ � <br /> Attach(our(4) copies of plans lor proposed work• Dravi to scale and note the followinc as applicable: � <br /> • Centerline of sireet <br /> • property Lines • Indicate North <br /> � Outline and dimensions of all existir.g and � Show any F�oposeG greding changes <br /> proposed structures onthelot � Show measurements � <br /> • Ezisting -nd proposed utilities <br /> DO NOT WRITE BELOW THI.", LINE O <br /> PERMIT CONDITIONS �\ <br /> 1.All calls for inspeclion shall be made 24 hrs.in advance-phone 259•8810. <br /> 2.All work shall be pedormed in accordance with lhis permit and current City of Everett Design and Construction � �I <br /> Standards and Specifications. � ' <br /> 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1•S00•424•55 . <br /> 4. InstaY rock construction entrance behind driveway as per city O <br /> standard#208 and erosion control as directed by PubGc Works <br /> Inspector. <br /> 5. Keep city streets ckan at ap times � <br /> 6. Curb gutter and sidewa&in the plat are new and undamaged, � <br /> any damage thereto sha&be replaced at the discretion of the <br /> Pubic Works Inspector. O <br /> 7.Any change in the drivavay cut must be approued by the PW In- <br /> spector,widlh at prop line imited to existing apron width. � <br /> 3. Connect ap root,yard and driveway drains to storm drain <br /> system proWded to bt. <br /> 9.Adjust wateshaY be comrakte t cu edf before driv ng on them. <br /> 10. Driveways P N <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> (J��// The undersigned owner/applicant hereby agrees ro hold and save harm� <br /> r 12ss the Giry of Everell from any and all claims for damages, costs, <br /> � /� expenses. or causes ot action that may arise because of installation <br /> � /`L� ,�v](� /a�� ���I' and mainten; �ce o( the improvement or other righbof-way use hereto <br /> ��/ applieA tor and further agrees to remove same upon notice irom lhe <br /> �� � Date City and to replace public property damaged thereby. <br /> Approved fo �ns ru4�ion ,� , � <br /> � � <br /> G , F �- �{�1 �J�( e,,,,,,,t 2- 9- 9�1 <br /> Date Date <br /> FI L INSPECTIO Signature ol Applicant <br /> Approved as Constructed WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> PUBLICWORKSDEPAFTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200CedarSireet BE DILIGENILY PURSUED TO COMPLETION.THIS PERMIT MAY fSE <br /> Evere�t,W.49820� CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259-8810 PROJECT OVER 90 DAYS DURATION. <br />