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/ <br /> �312 1�24�90 � pn�hcworkcPormna �",� <-� <br /> eia9.oen� = 90/2 796 _ <br /> AUUlicaticn For <br /> pu �a�i� wr���cs P� Rnne-�- P�o;oWF�e.�� 5 —_ � <br /> Less Ann�.Fee PaiJ S -- <br /> Balnncs Ouv S �"�� <br /> Print or Type Only <br /> Select Homes P.O. Box 7G& Mukilteo, WA 98275 827-�196 <br /> Ovmer Maihng Address City 7_ip Phone <br /> Owner <br /> Applieant Mailing Address City Zip Phm��e i <br /> Describe Pronosed work ._. New sinqle feanily residenr.e, Lot 2, Glenhaven Heights _ I <br /> ---- - W I <br /> Prolect Address lif known) �� �' �-�� 7' � r�� ��`_/��'� 1-J�S jr � <br /> Attach four(4) ccpies ot plans lor proposed work- Draa to scale and note Ihe following as applicable: �� <br /> a Property Lines • Centerline of s�reet ♦� <br /> • Outline and dimensions of all existing and • Indicale Norih � <br /> proposed stru[lures on ihe lot • Show any proposed gradinc� cha�+ges <br /> • Existing and proposed utililies • Show mea=urements p� <br /> 0 1 � <br /> —�DO NO�T\V�RITF BELOW THI� W <br /> PERMIT CONDITIONS � <br /> 1.All calls for inspection shall be made 24 hrs.in advance-4hone 259•8810. sq <br /> 2.All work shall bN performed in accordance with this permit ano w:rc��i i:iry of Everelt Design and Consiruction ♦ <br /> Standards and Specifications. <br /> 3.Call Location Undergr�und Service 48 his.before you dig.TOLL FREE NUMBER 1•800-424-5555. � <br /> �) . ANY CHANGE IN THL+ DRI7EWAY CUT MUST BE APPROVED � <br /> BY THE PUBLIC WORKS INSPS;.TOR. <br /> 5 .CCNNHCT DOWNSPOOTS i'0 T`EfR9�RB-�1RtiIi�t$. ��-'3�-tC- Di�iL����� '=�'Stt�+-� � <br /> 6 .RfiQP CITY STRSSTS CLEf,N AT ALL TIMES. <br /> i . ANY DAMAGS TO THE CURB ANll SIDIiWALK WILL BE REPAIRED �A <br /> TO THL+ SATISFACTION OE' THE PUBLIC WORKS DGPT. N♦ <br /> � <br /> � <br /> �� <br /> /� ACKNOWLC-DGEMENT OF CGNDITIONS <br /> ' �/� The undersigned owner,'applicant hereby agrePs to hold and save harm� <br /> i <br /> -y-- -- !ess the City of Everelt from any and all claims or amages. cos s. <br /> expenses, or causes of aclion �hat may arise because ol installation <br /> � 4� (1 ; -Z. � A ` and maintenance of lhe improvement or other righPof-way use hereto <br /> ����� iU applied for and further aqrees to remove same upon notic trom lhe <br /> Appruved tor onstruc;i ��-� � Cit and to replace puhlic property damaged thereby <br /> ��i <br /> � !/iC -�� <br /> � -_ '�. <br /> FINALI �PE IUN Date —�-�— <br /> Approved as Cons�ructed Signature of Applicar.t Dale <br /> WORK AUTHORIZED 0Y iHIS PEPMIT MUST 8E 5 RTED WITHIN <br /> everett PUBLICWORKSDEFARTMEJf 1gJ DAYS OF DATE PERMIT IS 13SUED AND THERFAFTER IS TO <br /> � 3200GadarStreet BE DII_IGENTLY PURSUED TO CfjMPL�TION. THIS PERMIT MAY BE <br /> Everett,WA 98201 C;NCELLED BY THE CITY UP('�J ANY STOPPAGE JF WORK OM THIS <br /> Phone:259-8810 PRO�`CT OVER 90 DAYS DI;RATION. <br /> � <br />