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Application For <br />PUBLIC WORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 (425) 257.8810 <br />TYPE OR PRINT ONLY To POSTING 1`E13 11 Zlui <br />Date 6-1-99 <br />Public Works Permit 0 qli ' 6 <br />Building Permit # 62615 <br />Public Works Fee $ 2D <br />North Crest Development PO Box 340 Edmonds WA 98202 425-774-3181 _ <br />Owner Mailing Address City Zip Phone <br />Owner <br />Applicant Failing Address City Zip Phone r�1 <br />Describe Proposed Work <br />naw hnuae <br />W <br />tttt� <br />N <br />PROJECT ADDRESS (if known) 4602 21st Dr 11W Lot 7 Bush Gardens W <br />O <br />Attach four (4) copies plans for proposed work - Draw to scale and note the following if applicable: <br />• Property Lines • Outline and dimensions of all ex,sting and proposed structures on the lot • Existing and proposed utilities <br />• Center ine of street - Indicate North • Show any proposed grading changes • Show measurements <br />DO NOT WRITE BELOW THIS LINE <br />PERMIT CONDITIONS: O <br />1. All calls for inspection shall be made 24 hours in advance - phone (425) 257-8810 <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and <br />Construction Standards and Specifications.. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. <br />'I. Keep city streets clean al all tiotes O <br />S. Curb gutter and Adewall: in fire plat are new aril undamaged, atry damage (hereto shall be replaced at the <br />discrefinn orthe Public Works Inspector. Oil <br />6. The I'VP Inspector must approve arty change in the driveway cut. Width at prop lice limited to exiAing apro <br />Width. <br />7. Adjnst water boxes to grade at end of construction. <br />8. T)dvcways sball be completely curad before dli,6ing ou them <br />9. Rooftop drainage shall be discharged to the slomt drain stub provided oft the lot. <br />ACKNOWLEDGEMENT OF CONDITIONS <br />�1 n The undersigned owner/applicant hereby agrees to hold and save harmless <br />Oroy y I ii �� the City of Everett from any and all claims for damages, costs, expenses, or <br />r i l causes of action that may arise because of Installation and maintenance of the <br />prove o s ruc Ion a e improvement or other right-of-way use hereto applied for and further agrees to <br />i remove same upon notice from the City and 10 replace public property dam- <br />` l° /� Z —%-!� agethere <br />FINAL INSPECTION Date ►/ ` V dl _ r -76 s� <br />Approved as Constructed I[.� ant �(`� <br />Signature or Applicantpate <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WTHIN 180 DAYS OF DATE PERMIT IS ISSUED MID TI E.FEAFtER ISM BE DILIGENTLY PURBUEDM <br />COMPLETION. THIS PERMIT MAYBE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PRO,ECTOt/ER 90 DAYS DURATKX <br />