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�_- . �.�,,::� . . . _„�,.., . _ _ _. . ... . _... _ _. . ..� .. .� <br /> ��........�..- <br /> Dat�� Pu�Oc No�ks Parmil i V7���--/���>— � <br /> ApplicationFor ema.o�o�-• ��i�i'L23�/T <br /> PUgLlC WORKS PERMIT Pu�t¢WorkSFee s = � <br /> Total Fae <br /> Le3a FpP�Fee PaiU s <br /> Baleoce�ue S ��— � <br /> Print or Type anly - <br /> ��_��n��" /SG G� �J�-7R �� �/c., �� ��:,1 ...p�,�" <br /> Owner Mailiny Address Ciry Zip Phor.e I <br /> 9 <br /> Appl� Mailing Address Ciq' Zip Phcne <br /> Describe Proposed Work `��� �� <br /> Project Address(if known) ��, ����0 — "�� th •AvE 'S�E � � <br /> � <br /> Attach four(4) copies ol plans for proposed work• Draw to scale and note the tollowing as applir,able: � <br /> • Property Lines w Centerline of stree: � <br /> • Outlina and dimensions of all existing and s Indicale North <br /> proposed structures on the lot O Show any proposed gracling changes <br /> • Exis�ing and proposed utilities • Shorv measurements � <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMiT CONDITIONS <br />. i. All calis for inspection sh�ll be made 24 hrs. in advance- phone 259•881 5. � <br />� 2. All work shall oe performed in accordance with this permit ard current City oi Everett Design and Construction <br /> Standards and Specitications. <br /> 3. Call Location Underground Service 48 hrs. before you dig.TOLL FREE NUMBER 1•S00•424•5555. � <br /> 4. ANY GRADING DONfi ON THIS LOT SHALL BE DONE SO AS :IOT TO IMPACT T3E <br /> SURROUNDINC IATS WITH RAINWhTER RUNOFF. � <br /> 5. ANY CURB & GUTTER OR SIDEWhLK D'AMAGED DURING CONSTRUCTION SHALL BE <br /> REPLACED BY THE APPLICANT. � <br /> 6. DOWNSPOUTS FROM THE HOUSE ARE TO BE TIGHT--LINED TO THE DRAII�AGE SYSTEM. N <br /> I O <br /> 7,ANY ORGANIC MATBRIAL ON SITE TO BE BURNED OR HAULED GFF WITH PERMITS. <br /> a <br /> AGKNOWLEDGEMENT f)F CONDITION5 I <br /> Th- i:ndersigned owner/applicaN hc:eby agrees to hold and save harm- <br /> less the City of Everetl from ami and all claims lor damages, costs, <br /> �� / � ezperses, or causes ot action that may arise because ol installaticn <br /> • `X�.���S�� ://L//�� and maintenance of �he improvement or other righhof-way use hereto <br /> �/�� ��/ � 7 applied for and furiher agrees to ramove same upoo notice from the <br /> Approved lor Constr tion Date ���y and to replace public properiy damaged thereby. <br /> - Z(z31� 1A <br /> FINAL INSP[CTION �a�e —'' �� �"`�"� �'�`�� <br /> „pproved as Constructed Si nature of Applicant Date <br /> PUBLIC WORKS DEPARTMENT ORK AUTi10RIZED BY THIS PERMIT MUST 6E STARTED WITHIN <br /> everett 180 DAYS OF DATE PERMiT IS ISSUED AND THEREAFTER IS TO <br /> � 3200 Cedar Street BE DILIGENTLY PUFSUED TO COMPLETION. THIS PERI,�IT MAY BE <br /> Evr.re�t.WA 3�201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />` Phone: 255�(1815 PROJEGT OVER 90 DAYS DURATION. <br /> L <br />