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Applicauon For <br />PUBLIC WORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Evaretl, NiA 98201 (425)257-8810 <br />.NN 1 4 Z� <br />TYPE OR PRINT ONLY j V POSTING .. <br />\ <br />Date <br />6-1-99 <br />Public Works Pertnit 8 � I�� <br />euilding Permit M 62616 <br />Public Work; Fee $ v0 <br />North Crest Development PO Bo:c 340 Edmonds WA 98202 425-774-3181 <br />Owner MailingAddress City Zip Phone <br />Owner <br />Applirant Mailing Address City Zip Phone r, <br />Describe Proposed Work new <br />PROJECT ADDRESS (i( known) 4614 21st Dr <br />Lot 10 <br />Attech tour (4) copies plans tor proposed work - Draw to scale and note ihe tollowing il applicable: <br />• Property Lines • Outline and dimensions ot all existing and proposed structures on the lot • Existing and proposed utilifies <br />• CenteAine of street • Indicate North • Show eny proposed grading changes • Show measurements <br />DO NOT WRITE BFLOW THIS LINE <br />PERMIT CONDITIONS: <br />1. All calls for inspection shall be made 24 hours in advance - phone (425) 257-8810 <br />2. Ail work shall be performed in accordance with this permit and current City oi Everett Design and <br />Construction Standards and Specifications. , <br />3. Call Location Underground Service 48 hrs. before yeu dig. TOLL FREE NUM9ER 1-800-424-5555. <br />i F.ecp cih� streets ciran at :dl timcs. <br />- Cwfi g�Ute� and :a�iz�valk ir, lhe pla( :u'� urw aud uud:nn;iEed, any danra{;e Ihcreto sludi be replac<d al ihe <br />discrctioii of Ui� Public lYoiks Gispcclor. <br />� 'The I'\�' [nspzctor musl approvc ,ury change in the d�ivatr�;ry cul. Widih a� prop liue limited tu etisli�g a <br />widlh. <br />- Adju;t water boxes to Er.{de at eud ol coushuction. <br />i Ttii�ewa}•:; sh�dl be eornpiclely cured bcfora dri�ing mi ihent. <br />�. KooRop drainae,� sliall bc discharged to the sto�m draiu shib provided on die (ot: <br />� <br />FINAL INSPECTION <br />Approved as Consimcted <br />"Ji <br />W <br />� <br />�� <br />V / <br />� <br />O <br />� <br />V/ <br />O <br />� <br />ACKNOWLEDOEMENT OF CONDITIONS <br />The undersigned ownedapplicant hereby agrees to fwld end save harmiess <br />the Ciry ot Everen irom eny and all claims for damages, casffi, expenses, or <br />causes of actlon thal mey ar�se because of installation and meintanance ot the <br />improvement or other righPof-way use herero applied lor and further agrees to <br />remove same upon notice from the Ciry and to replace Wa� P�KY �' <br />eged tlie�eby <br />��� � �-� IRq <br />Sig re STA�p i �— <br />NA7RK AUT}iOR�D BYiHIS PEFIMfT A1UST BE STAFifED WITHIN 180 DAYS OF DAiE F'ERMff IS SSUEG AND T}EFiEAFIER IS 70 BE OLJGFIJTLY PURSl1ED TO <br />CONIPlEfION. THIS PERMR MAY BE GANC�.LED BYhE GTY UPON ANY STOPPA(iE OF WOFiC ON TFAS PHO�ECTOVER 90 DAK�, DUWITION. <br />