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TYPE GR PFviNT ONLY <br />ApPlication For <br />PtJBLIC WORKS PERMIT <br />FUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Evereit, WA 98201 259-8810 <br />��+ PASTlNG <br />James Matteson 15418 29th Ave <br />Mailing Address <br />AUG 0 A 1997 <br />Date _ 1—ZZ-97 <br />Public Works Permit» _�_/� � V <br />Building Permit» _` 4032 <br />Public Works Fee S _ _.:.,Cl —_- <br />11 Cieek [dA 980] <br />Zip <br />Owner -- <br />Applicant Mailing Address City Zip Phone � <br />�� -:,-: - <br />Describe Proposed Work <br />�JOC� : r''r <br />-„ �,� ,<<_� ,t <br />- - �.,,: n � <br />, - �, .�r,� r.n <br />PROJECT ADDRESS (if known) [ �r/ �/ v' '' �� � Lot 4 SP � <br />;i_::, r _ <br />Attach four (4) copies of pians for proposed work - Draw to scale and nole the following if applicable: ;.;".�-'. -,:. �� <br />•Property Lines •Outline and dimensions of all existing and proposed stmctures on ihe lot 'Existing and propoS9d k�U�ities <br />•Centerline of sireet •Indicate North •Show any proposed grading changes •Show measurements ,; �„ ;�,. <br />_ �,�� <br />DO NOT WRITE BELOW T',�IS LINE -;� _'"" <br />[:y;�::: , "^,'JO <br />PERfJIIT CONDITIONS: <br />1. All calls for inspection shall be made 24 hours in advance - phene 259-8810. '�^'�; '`' '`"} <br />2. All work chall be performed in accordance with this permit and current City of Everett Design and <br />Construction Standards and Specifications. <br />3. Call Location U�derground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-500-424-5555. <br />I K,,cp ciiv �irccts cicau ;it sli tnuu<. <br />�. i'uib �ntldr,md si�l�w;tli: ui ilic pl;it ar u��.v vid unil.m�a��il, au�� d:iuia,�c ihcrdlo �h;Jl b� r�pl,uerl ;d II <br />discroiiou of Ihe Public �y'orLs l�spector. <br />G. Nrv chan�•e ui �he drivcw:ry cut must bc apE�roved bV Ihe PW Inspector, width �t prop linz limilcd io <br />c.�istiug aprou widlh. <br />7. Adjust w;dcr box�< lo �adc al dnd of constmction. <br />8_ llrn��w;ry�s shall be compleleiy cured bcfore cUivin� on them. <br />�, hnoiiop rlrnumnr shnll be rJisr,hnrn�rt lo ihr =torut �Ieiin;�_,� shih lordrrl af tl�e'innt r,f�the Inl <br />7/� 7 <br />i3 •�'f+G �i� �-2,p_97 <br />FINAL INSPECTION Date <br />,4pproved as Constructed <br />� <br />0 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby ngrees to hold and save harmless <br />ihe City of Everett frem any and all claims for damages, costs, expenses, or <br />causes of action that may arise because of ins!allation and maintenance of <br />the improvemenl or other rigM-of-w ay use hereto applied for and further agrees <br />to remove sameypon notice from ihe City and tu replace public property <br />damaged the�T. <br />o-S <br />WORK AUTHORIZED BY THIS PEFNIT M�1ST BE STARTED WITHIN 1B0 DAYS OF DATE PERt�f 1S ISSUED AND THEREAFfER IS TO BE DILIGENTLY PURSUED TO <br />CGMPLEfION. THIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANY STOPPAGE OF WORK O�J THIS PROJECT OVER 90 DAYS DURATIGN. <br />