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❑ <br />PUB��c woRKs <br />PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everen, WA 98201 <br />w25, 2�-�'°PCSTI N G <br />ANDADDRES�O BOX : 1 <br />MANSOfv' <br />PiioNE: ( 206 ) 550-4245 <br />TAXPAqCELI.D.N �Q'rj.'j$j <br />DESCRIPTION OF A'� <br />PROPOSED WOFK: <br />f�W <br />PERMIT CONDITIONS <br />Wh 98831 <br />)����Q <br />— F�ASZC 2179 <br />SEP 2 3 20U2 � <br />PHONE: <br />Date 11/06/2001 <br />Public Works Permit aPW0111-006 <br />Building Permit a <br />Plannint� Relerence !1 <br />Put ic Works Fee S <br />Guarantce S <br />PROJECTADDRESS:lOG�;S ?IST AVF. W <br />C0111-004 <br />$25.00 <br />1. All calls for inspection shall be made 24 hours in advance - phone (425) 257•8810 <br />2. All work shall be peAormed in accordance with ihis permil and current City o( Everett Design and Construction <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBEH 1-800-424-5555 <br />4. Contact Mukilteo Water Listrict Eor conne�ting provisions to tiieir <br />systems. <br />5. Install a Type I concrate driveway per City of �verett Standard 3G7 <br />Pave to mcet 21st Ave. W <br />6. Pip_ rnoftop draina�7e to an in£iltration system per City of Everett <br />Standards Storm Manuai �-2.ti.2. Ia 3', D-:t.�i', L- 21'. <br />i <br />S`b��,�l� ) <br />lor ConSlmction <br />� 'e�/•+`fr- � ,�-yz�— <br />FI AL INSPECTION <br />Appro'ved as Constmcted Date <br />.. ,_� <br />tCNG <br />GR; !Jc' <br />_r.{ <br />��U�;2 <br />^LAN f„ <br />-+ Ol'A!_ <br />_,,, <br />lUf•", i`_; <br />4.::` <br />25.;0 <br />�O.CG <br />"r7,U� <br />J.O. 4': <br />.12�r9. � i <br />/ <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned ownedapplicant hereby ayrees to hold and <br />save harmless ihe City of Evemtt irom any and all claims for <br />damages, costs, expenses, or causes ol action thal may arise <br />because of installation and maimenance of the improvement or <br />other righ4obway use hereto applied lor and turther agrees to <br />remove same upon no�ice from the City and to replace public <br />pro erty amaged ihereby. <br />\� �_� � V Z <br />Signawre o� Applicant Dat <br />WORK AUTH'JRIZED BY Ti ii.^, FEflMIT MUST BE STAHTED WITHIN 180 DAYS OF DATE PEflMI'i IS ISSUED AND THEREAFTEfl IS TO BE DILIGENTLY PURSUED <br />TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANV Sl OPPAGE OF WORK 0Y 7HIS PROJECT OVER 90 DAYS DURATION. <br />