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Date ��Z6/83 <br />Applicat�on For <br />PUBLlC WO�K� PER�'�lIIT <br />Frint or Type Only <br />Hillis Homes Snc. <br />Same <br />Applicant <br />826 S.E. Everett Mall Way <br />Mailing Address <br />Mailing Address <br />City <br />City <br />Irstall 25' wide concrete driveway <br />Describe Praposed Work <br />� <br />Project Addre:s (if known) <br />PULiic Works Permit a "� ` " � — <br />eme�oao�.r 83/12265 <br />Publit Works Foo $�..;) � p p <br />Total Fee <br />Less AnO� Fce Pa�tl $ <br />Balance Due 5 � - p � <br />Everett 9R204 355-4492 <br />Zip Phone <br />� <br />Attach four !41 copies of plans for proposed work - Draw io scale and note tha following as applicable: <br />• Property Lines • Centerline of street <br />Y Outline and dimensions of all existing and • Indicate North <br />proposed structures on the lot • Show any proposed grading changec <br />• Existing and proposed ulilities • Show measuremenis <br />for <br />PERMIT COIJDI�i IONS <br />1. All calls tor inspection shall be made 24 hrs, in advance - phone 259-881 5. <br />2. All work shall be performed in accordance with this permit and currer.t City of Everett Design and Constniction <br />Standards and Specifications. <br />3. Call Location Underground �+rvice 48 hrs. before you dig. TOLL FREE NUMbER 1-500•424•5555. <br />� <br />FINAL INSPEGTION <br />Approved as Constructed <br />everett PUBLIG WOR S DEPARTMENT <br />� 3200 Cedar Street <br />Everetl, WA 93'eG1 <br />Phone: 259-8c 1 S <br />�-/- �"� <br />j � Uate <br />FChNOWLEDGEiAEA;T OF CONDITIONS <br />The undersic�ned owner/applicant hr.reby agrees to hold and save harrr.- <br />less the Ciry of Everett irom any and all claims for damages, costs, <br />expenses, or causes of action that may arise because uf installation <br />and maintenance ot lhe improvement or other right-ohway use hereto <br />applied for and turther agrees to remove same upon notice from the <br />Citv and to replace public,Y�roperty damaged thereby. <br />✓4. f '{' u S � <br />Sign r2 of Applica t Date <br />WO AUTHPRIZFD BY THIS PERMIT MUST BE STARTED WITHIN <br />1� UAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />6E DILIGEnTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCEI_LED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJEt:T OVER 90 DAYS DURATION. <br />t <br />� <br />