Laserfiche WebLink
Pu�lic Works Pormi�a �� ,/� / <br /> Date 1-12– 5 �Q �1�S�I�G �- Z (� q5 _ emg.oeai.. G6729 <br /> qpplication For � <br /> pUgLIC WORKS PER�IIIT °°°'"'"°"=`r° S- <br /> Tolal Feo <br /> ¢ �>ss PpJL Fee PaIJ §� <br /> O � �' <br /> p p p ue 5 <br /> y O O O O N O O ��'So-P <br /> Print or Type Only Q , <br /> O �i- OO �tG L) � �00 rt <br /> m � mMMiA � M `� � �M .�i <br /> Steven BartJ.ow Const 3711 122nd Pl SE NEv�ett 98208 3�7-9�99 � � phone ' <br /> Owner Mailing Address o��� �(n'�Y = � � o o � <br /> p\ 0 � j W � iUi". f O � O W � Z <br /> C� yC fi] 0. X G] Vl Gl �t 3 3C [A [n [-� <br /> OwneT �i�Y Zip Phone � <br /> Applicar.l Mailing Address � � <br /> � <br /> Describe Pro;�osed Work <br /> new house <br /> W <br /> 5828 llth Ave W Lot 70 Merrill Crk Garden� ` <br /> � Prolect Address(if known) � <br /> � Attach four(4) �opies of plans tor proposed work- Draw to scale and note�Ceoterline ol slpeP�cable: � <br /> . • Property Lines • Indicate North <br /> ! Outline and dimensions oi all existing and � ghow any proposed grading changes <br /> proposed slrur,tures on the lot • Shovi measurements � <br /> • Existing and proposed u�ilities <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS � <br /> 1.All cali��or inspection shall be made 24 hrs.in advance-phone 259•8810. <br /> 2.All work sha�l be pertormed in accordance with this permit and current City of Everett Design and Construction <br /> Standards and Specifications. � <br /> 3.Call l.ocation Underground Service 48 hrs.before you dig.TOLL FREF NUMBER 1•800•424-555 . <br /> I g_eep cih�, streets cle�ui �1 all tunes. � <br /> 5, Curb euiter a��d sidewalk in ihe �lat;uz new:uid undamaved, arry dama�e ihereto shall Ue replaced ai Uie <br /> dis�rctimi of th� PubGc 1t'otks Inspcctor. <br /> F, Am chanee in the drivew;rv cut must be sipprnved by ihe Public Works inspector, w�dth at prop I;ne � <br /> � I11i11IZlI (O CJ[ISIllI�;8�)IOII Wll���l. U171'GW�}' Illil}' �:I�CI�J���118IIY �� IIICC� �'71(�KC 1I0U1 CIII18Ill'C (�UI ;111 <br /> �pproi��d 3 car��r;ise). P A <br /> i, ndjusl w�ter boxes ro erade at end nf conshuctiou. �♦ <br /> o. D�ivctie;ry�s sliall bc complcicly curcd bcforc dmvig on thcm. O <br /> 9. P.00ftop drainag:: shall be disch�rgeJ to ihc Iots udiltration trench as par the "Residential Foof Downspout <br /> SYs�am" dei�i�(ahacliod) and as per�h� sizine:md loeatiou iufomiaiion on the lot's siie p�a�i• �� � <br /> prccousUuction meetino must be �cheduled�F1ih �Uan Loclie (353-965$ mob. or 259-SS10 olTice) prioi io <br /> inslallaljon nf(he intiltr,dion system Am eh:+noe in the inYilhation trench must be approved by thc Yublic <br /> 1Fuiks Iuspcclor. <br /> ACKNOWLEDGEMENT OF CONOITIONS <br /> The undersigned owner/applicant hereby agrees�o hold and save harm� ' <br /> — less ihe Gity of Everett irom any and all claims for damages, cosis, <br /> � �/ � � �� eapenses, or causes of action ihat may adse because of installation <br /> � n , � and maintenance of the improvemenl or other right-ol�way use hereto <br /> G��v applied tor and rther agrees to remove same upon notice from the <br /> Approve �` <br /> for Construction Date City and to re ce blic properry damaged thereby. <br /> � 1/�� %- �- %� Z ' ( '��S <br /> � "`��" ' Date Date <br /> FINA! INSPECTION ignature o�Applicant <br /> App�oved as Constructed WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> � PUBLIC WORKS DEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200CedarStreet BE DILIGENTIY PURSUED TO COMPLETION. THIS PERMIT MAY bE <br /> Everett WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259�8810 PROJECT OVER 90 DAYS DURATION. <br />