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�ate � . _ __ �� _�� ,�'G PuCLc Works Parmlt a _(� / <br /> '� �'P� Pd�TIN� <br /> �—��l-- �id9.DePL<_ 1.�i7�(1 <br /> Application For �,� <br /> PUBLIC WORKS P�11AIT PublicNorksFee <br /> 7alal Fee � <br /> �p Less A00�.Fee Paid $ //� <br /> O "�� <br /> C'� O O � O O O ej�ancc Due S <br /> Print or Type Only � u o 0 0 �n o o n � <br /> � o� L� 003' O ON �O � <br /> N .�pt�4 � A � � � M .�+ � <br /> � �p w W —� <br /> Select Homes Inc 12811 8th Ave W Ev�Yett 98204 5�'i-9�6 ` _ _ <br /> Owner Mailing Address 7 � � ���Y� 3 0 [µ� � ��� .� Phune <br /> �M OL9 'V � C] = ?.,� OF� 03 [��Jl W <br /> O 004] C.1 OJ Ll <br /> Owner \ � JJI'� p� � � OQO W .: T <br /> J 7FC] fa. S O :1L3 � Ultl'1 V <br /> Applicant �Aailing Address City Zip Phone <br /> Describe Prcposed Work new house -� <br /> � <br /> Proiect Address(if known) <br /> 5815 llth Ave W Lot 73 Merrill Crk Gardens � <br /> � <br /> F"ach four(4) copies of plans for proposed work- Draw to scale and note the following as applicable: � <br /> • ?roperry Lines o Centerline ol s!reet <br /> • Outline and dimensions ol al. zxisting and • Indicale North <br /> ,roposed structures on the Io1 • Show any proposed grading changes <br /> • Existing and proposed utilities • Show measurements � <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITInNS � <br /> 1.All calls for inspection shall be made 24 hrs.in advance-phone 259•SS10. <br /> 2.All work shall be performed in accordance with this nt�rmit and current City of Everett Design and Construction <br /> Standards and Specifications. � <br /> 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1-800•424•5555. <br /> q. Kecp city, sh'cets cican at atl fimes. <br /> 5. �urU eutter a�iJ sidewaik u� ihe �,lac a�e new aud und�una�ed, a�ry damage �hereto shai br, replaceJ at lhe O <br /> � discretion of lhe Pubfie ��'orLs Inspector. <br /> G. Arry chanve �n ihe d�ivewarv cut must Ue approved by Ihe Fublic Works Tnspeclor, width at prop 6nt <br /> IIIW�CII 10 CX15�W� J�IIUII WIIIIII. DIIS'CWBY IIIBy' 1:1�1C!�'18(I118IIy l0 IIIGCI K817KC (IOOC CIIU-:IIICC (P01'Jll L <br /> �ppro��ed 3 c:v garagc). r <br /> �. Adjust water boxes to erade at eud of construction. � <br /> "o. Diivew:+ys �h�ill bc complctcly curcd bcforc drivu�g on thcm. O <br /> 9. Rooftop dr;w�age chall be Jischa�sed to tlie lots uililtralion trench as per the "Residenrial Foof Dewnspout <br /> �ysiem" deiail(atlachrd) :uid as per the sizine and location uitortnation on the lot's site pla��. A � i <br /> preconstniction mezlin�;must bc schcdulcd wilh Alla��Loci:e (35*u•9655 mob. or 259-3310 olTice) �tior to <br /> inst�llation of the intiltration system. Arry cti�n�e in the inlilh.rtion trencli must be approveci by the Fublic <br /> �Vo�l,s Lispcclm. <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm- <br /> less the Ciry of Everetl Irom any and all claims lor damages, costs. <br /> {�1� �/ '7expenses, or causes of action ihat may arise because of installation <br /> �'/ 1 Gi "- ,� (�/�/�� and maintenance of ihe improvement or olher right-ol-way use hereto <br /> applied for and further agrees lo remove same upon notice Irom ihe <br /> Appr�d to`onstruction � � Date City and to replace public prop,erty damaged thereby. <br /> '� � % <br /> J,�1! �-o� 3- y � � � <br /> � �3 �S <br /> FINAL RJSPEC710N �a1e Date <br /> Approved as Constructed ign2lure of Ap icant <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED VJITHIN <br /> PUBLIC WORKS DEPARTMENT 180 DAYS OF CATE PERMIT IS ISSUED AND TNEREAFTER IS Tn <br /> 3200CedarSireet BE DILIGENTLY PURSUED TO COMPLETION. THiS PERMIT MAY BE <br /> Everelt,WA98201 CANCELLED BY THE GTY UPON ANY STOPFAG�OF WORK ON 1�HIS <br /> Phone:259•8870 PROJECT OVER 90 UAYS DURATION. <br />