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Date 1-12-95 �������yTING ��G� P°bbcWorksPermits ��O'� � <br /> � am�.oeai.• 46730 <br /> Application For o <br /> PUBLIC V'JORKS PERII�IT Pu�hcWorksFea <br /> totai Foe 5— <br /> ¢ Less Appl.Fee Pala � <br /> O <br /> To pasri�� � o � o 0 o a ��� $ �-- <br /> Pririt of TyF�e Only z �'b � o o �n o 0 <br /> `� o � o o + ri vi o rd vi <br /> °'� i°�ra � u .'-'rten � n � � o <br /> ai +w e� "i+ .�'-i <br /> Steven Bartlow Const 3711 122nd P1 SE rEve�ett 9820II 33,'�90� "' <br /> Owner Mailing Address o:� �o City � '- � Zipo� > Phone <br /> � � a r.a w �• <br /> p�. q G1 O 2 CJ S :s d O � O f_1 <br /> O t7 [� � U � f-� "'� l7 � 3 VI W <br /> �4/RBT <br /> 1 � iil fJi. Z il � � � 3 � Ul Ul U <br /> Applicant Mailing Address City Zip Phone <br /> Describe Proposed Work new hoi�cP �\\ <br /> ��: <br /> W <br /> ProiectAddress�ifknown� 5809 llth Ave W ___ Lot 74 Merrill Crk Gardens � <br /> Attach (our(4) copies of plans (or proposed work• Draw ro scale and note �he tollowing as applicable: � <br /> • Pruperry Lines • Centerline of s�reet pA <br /> • Outline and dimensions of all existing and • Indicate Norih V� <br /> proposed strucfures on the lot • Show any proposed grading changes <br /> • Existing and proposed utilities • Show measurements /y� <br /> W <br /> DO NOT WRITE 6��LOW THIS LINE � <br /> PERMIT CCt�DITIONS <br /> 1.AI!;;alls for insp?ction shall be made 24 hrs.in advance-(�hone 259•8810. � <br /> 2.All work shall be performed in accoidance with this permii and current City of Everett Design and Consiruction <br /> Standards and Specificatlons. y,g <br /> 3,Call L4C`�,n�`de�rgro[S ele',eiii 1teall .'IITICbetore you dig.TOLL PREE NUMBER�-$OO•4Z4-S5S5. u> <br /> 1 K G <br /> i. Curb euiter and sideN��lk ui t!ic plat a�e new a�id und;tin�e.ed, :ury da�nage ihereeo sliall be re�laced at the � <br /> Jiscrclion of�he PuUlic \t'orl:s Lisuector. <br /> (,. Atry change in fhe dnvew�y cnt nmsf be approved 6y thr. Fnlilic Works lnspector, widtl� at prop line � <br /> IIIIIIICII (U CdISlill� e�)IUt! WIIJIIi. D11VCW�Y III�y (JOCI �19(Ill:l�ty �u IIICCL K;llB�'C lIOUI� CIIII�8111'C (P01�8t1 ■ <br /> spproved 3 car ger��e). � <br /> Adjus� wa�er boxrs to Pi:IAZ :If CII(I OI COfIS1i71CI1011. '^ <br /> 3. Diiv�ways sh�ll bc couiplctcly ciue�bcforc driviug on Urem. �s <br /> 9. Rooftnp drtinaee shall b: di�chsreed ro the (ots inliltrafion trench as per ihe "Residcn�ial Ronf Pownspo�d I� <br /> System" de�ail l�nached) and as per tl�e siang :md locaiion infonnarion on die lui's site plau. A � <br /> pr�couslniction mectino mus! be scl�eduled witl� .11an Locl:c (33S-9G.55 mob. or 259-881(� officc) p�ior to <br /> ins��llation nf the intilir�tion spstem. Airy chan.v,e in ihe infiltr�tion trench must be npproved by the Fublic <br /> Wmlc. L�apedvi. <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees lo hold and save harm- <br /> -�— less the City ol Everett Irom any and all claims for damages, costs, <br /> {�'�// ,�'��,�/1 Z '] r ezpenses, or causes of ac;iun that may arise because of installatior. <br /> �_! LL '�L��"!' ' y'��`� �/ /"/J and mainten2nce of lhe i,nProvement or other righbo(•way use here�o <br /> applied for and further agrees to remove same upon notice trom the <br /> Approved for Construction � Date City and to replace pubf properry damaged thereby. <br /> ,.yL-_.��- I'l'-/- 7`�/� � <br /> FINAL INSPECTION Datz � <br /> Approved as Conslructed ignatuca- PPlicant Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED INITHIN <br /> ' PUBLICWORKSDEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200CedarSlreet BE DILIGE:NTLY PURSUEG TO COMPLETION. THIS PERMIT MAY 3E <br /> x Everett,WA 9�201 CANCELL�=7 BY THE CITY UPON P.NY STOPPAGE OF WORK ON THIS <br /> Phone:259�8810 pROJECT OVER 90 GAYS DURFTION. <br />