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�a5 � ` Puobc Wads Parmit• ✓��// � <br /> Application For - eia9.oer�.._� (,c.� <br /> PUBLIC W�RKS PERMIT PubbcWorksFee <br /> Total Fee S <br /> , Less Apo� Fee Pa�tl $ 4O� <br /> Print or Type Only ea����eo�e S <br /> � - . c.r�� -/o�� /G�.�// -//3 �,oSG �,e�a�U,/J ..:3�3� ���0 <br /> Owner Mailing Address City Zip Phone <br /> `� — <br /> Applicant Mailing Address City Zip Phone <br /> Describe Proposed Work �r�\ <br /> Projec:Address(if known) ��' `�e-� ��2i!•� ���� ���7/�� ✓'�t�IqYE � <br /> . J'-L�'_ � <br /> Attach four(4)copies of plans�or proposed work� Draw to scale and note the following as applicable: � <br /> • Prouerty Lines • Centerline ol street � <br /> � Outline and dimen5ions ot all existing and • Indica�e North <br /> proposed structures on the lot • Shc a any proposed gradim� changes <br /> • Existing and proposed utilities • Sh�w me:�surements � <br /> DO NOT WRITE 9ELOW THIS LINf_ <br /> PERMIT CONDITIONS O <br /> 7. All calls for inspection shall be made 24 hrs. in advance- phone 259•881 5. � <br /> 2. All work shall be performed in accordance with thic permit and current City ot Everetl 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 /> 4 . ANY GRADING DONE Od THZS TAT SHALL F3E DONE SO AS NO�1 TO IMPACT THE O <br /> £iURROUNDING 7,OTS WITH P.AINWATER RUNOFF„ <br /> 5, ANY CURB & GUTTER OR SIDEWALK Dr1IsAGED DURI[dG CONSTRUCTION SHALL BE � <br /> REPLACED BY THE APPLICAtdT. <br /> 6. DOWNSPOUTS FROM THE HOUSE ARE TO BE TIGHT—LINED TO T.H3 DRAINAGE SYSTEM. � <br /> 7.ANY ORGANIC MATERIAL ON SITE TO BE BURNED OR HAULED OFF WITH PERMITS. O , <br /> a ' <br /> ACKNOWLEOGEMENT OF CONDITIONS <br /> 7 he undersigned owneryapplicant hereby agrees to hold and save harm- <br /> less the City ot Everelt hom any and all claims for damages. cosis, � <br /> �_ ' ��.epenses, or causes ol action that may arise because of installation <br /> � f»�l�_ .e//��6 � and maintec�nce of lhe improvement or other riqhbof-way use hereto <br /> --�� applied for and 'rur�her agrees to remove same upon notice from the <br /> Approved for onst uction Date City ond to re e p -c property damaged thereby. I, <br /> h <br /> l0 17�+� � ' � _ _ <br /> FINAL INSP CTIO ' Daie � <br /> Approved as Construcled Sic,n, rN ol plicant ate <br /> evcrett PUBLIC WOfiKS DEPARTMEN�i W �� AUT ORIZED 9Y THIS RMIT MUST BE SiARTED WITHIN <br /> � 3200 Cedar S�reet 78U UAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett,WA 98201 BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIi MAY BE <br /> Plione: 259-8815 CANCELLED BY THE C�TY UPON ANY STOPPAGE Of WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />