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TYFE OR PRINT ONLY <br />Applicotion For <br />pt1�LIC WOR�CS PERMl� <br />?UBLIC WORKS DEPHRTP�IENT <br />3200 Cedar Slreet <br />EveretLWA98201 2ss-ee�oAUG p h iQo� <br />��° PO�TING <br />Date 1-22-97 <br />�G%/0<FZ <br />Public Works ?ermit # _ ` <br />Building Perm�t i1 __ _ 54030 - <br />o" <br />Public Works Fee 5 - <br />Kay/James Diatteson 15418 29th Ave SE Dtill Creek WA 980P2_ 316=83FlPnone <br />Owner <br />Mailing Address City <br />Describe Proposed Work new house ____— <br />[ip <br />Lot 2 SP 1� �v �� <br />PROJECT ADDRESS (if known) ��..� � ' "' " <br />Attach tour (4? copies of plans for pmposed work - Draw to scde and note the foilowing if applicable� <br />•Property Lines 'OuUine and dimensions of all existing and proposed stmctures on the lot 'Exisling and proposed utilities <br />•Centerline of str�et •Indicate North 'Snow any proposed grading chan9es 'Show measurements <br />PERMIT CONDITIONS: <br />1. All calls for inspection shaii be made 24 hours in advance - phone 259-8810. <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and <br />Construction Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER,1.-S00-424�5555,,, _. <br />� <br />�. <br />fi. <br />✓, <br />� <br />`!5pC�5�::�_;.,�.-: <br />�,� 3. � <br />F:. rp �i14 sh �.:Is daan at alI tunc:. �� <br />Curl� Eult�r.rnd <id:«a(I�, u� tlt� plai ,i,� n�u� imd w�d i�ua�,�aJ, .u} dmn;it tir-r�to shall�S��z�ad�d .�t ii <br />discrc�ion of �he Public Works Insprclor. qS•�rrc�: >', �� <br />Nry cl:angc in ihr diiveway cut umst bc approved by die PW Uispector, w}f�11�v�U,,prop lit�F L�ui�� il �u <br />e�is�in;:q�ron :vidth. `•;7LCDo"° <br />Adiust wator hoxes In erade at end of consuuction. ;,!aTEF: �;._"�.':- <br />ll�ivewa}�s shall bc compkt�ly curad bclor: drivim; on them. :I'.�,OO-OSLS <br />T:nnit��p d�ciieia�,� sh;dl be �;i<cf�,�rs��;l tn �I�e =lmin tir;iinr�.� :,Inb Incaled at (k1F;I�EQnt oF�f1Ct�,t <br />��q���� .<• =.... <br />� <br />Z <br />� ,`l� ( � ��57 <br />FINAL INSPECTION � Date <br />Approved as Con�tmcted <br />Z <br />� <br />ACKNOWLEDGEMEIJT OF CONDITIONS <br />Tre ur�dersigned ownedapplicant hereby agrees ic hold and save harmless <br />Ihe City ot Evere!� from any and all cfaims for damages, costs, expenses, or <br />causes of action ihat may arise because of installation and maintenance of <br />the improvement or other right-of-way use hereto applied for and furiher agrees <br />to remove same u on notice trom the City and to replace public property <br />damagedthzreby/ <br />G-/U- <br />� v <br />COMPLETIG.N. THIS ERMIT MA YB CANCEL ED BYTH�E CINIUPON ANY S�TOPFAGE OFM1WORK ON THI�rpROJECT OVER 90 DA SEDUFl TIONLY PURSUED TO <br />