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Gate 1/24/90 <br />Ap{Slicalion For <br />����dr,; lIVO�iKS PERMI� <br />Print or Type Only <br />Select HOmes Y.q. Box 708 Piukilteo, A:A ;�?'S <br />Owner Mailiny Address '� i;p <br />Owner <br />Applicant <br />Mailinp Address <br />827-8196 <br />Zip <br />lity Zip <br />/ <br />�-x' /� CF <br />r�ei�c wo�ws aermn + ( <br />eia�oea�» 90/23815 <br />Pumk worFs f ce <br />To�al Fec S <br />Less Aopl. Feo P,i�� $ <br />Balance pue $ ��� <br />Describe Proposed Wurk _. r�ew ::in�le family residence, Lot 23, Glenhaven H��_a�.,ts <br />Projec� Address (il known� <br />�- i�a A�c� � 1 � , r <br />Attach four (4j copies of plans for proposed v+ork - Draw to scale and note the following as applicable: <br />• Prcperty Lines <br />• Outline and dimensior�s of all existing and <br />proposed structures on the lot <br />• Existing and proposed utilities <br />�� <br />• Genterlme of street <br />• Indicate Norlh <br />o Show any proposed grading changes <br />• Show measurements <br />Phone <br />PERMIT CONDITIONS <br />t. All calis for inspection sha�l be made 24 hrs. in advance - phone 259•8810. <br />2. All work shall be pertormed in accordance with this permit and current Ciry of Everett Uesi�n and C��nstruction <br />Standards and Specifications. <br />3. Call Location Undergrountl Service 48 hrs. before you �ig. TOLL FREE NUMBER 1•800-424•5555. <br />4.ANY CHANGL� IN THfi URIVEWAY CUT MUST BE APPROVGU <br />BY THE F[IBLIC WqRKS INSPECTOR. <br />5. CONNECT Dc�WNSF0UT3 TO '�'�'�"za�,�-v^'o'-P,-^�^v^nfl-i-FtS- P�f3��c via�,r,�k,e �,�5�� <br />6.KL+FP CITY :TRE+ETS CLEP.N AT AL�, TIMGS. <br />7.ANY UAMAGQ Tn THL CURB APiD SIDI?WAGK WILL BE RGPAIREb <br />T(' 'PH� SAT1 ;17ACT]:Ot1 OF TH[: PUf3LIC WORKS DFFT. <br />U <br />Approved for ConsUu �ion � ��ale <br />�i <br />�/.�1/j� ��-d�-5'/ <br />FINAL ii�18��0� ' Date <br />Approved as C:,nstrur,�ed <br />e�erett PUBLIC WORKS DEPA9TMENT <br />� 32C0 Cedar Street <br />EvereU, WA 9�201 <br />Phone:25P�8810 <br />ACKNOWLEDGEMENT OF CONGI?IONS <br />The undersigned ewnedapplicant hereby agrees to hold and save harm- <br />less the Citv ol Everel� irom any and all claims lor damages. costs. <br />expenses, rr cacces of action iha, may arise because of 1�nstallation <br />and ryaintenance cl �he imprwer�enl or o�her righ ol-wa �Lse hcre�o <br />appl/ d lor and further n9rees I �emove sam u on n ice from �he <br />C'ty�nd !o repla�e public pPPerty dar�99ed th�. ��_'fi Gn <br />i i i i i '� ��v <br />Si9nalure of Appiicant � I' Date I <br />WORK A'JTHORIZED BY THIS '�ERMIT MUST BE� TARTED WITHIN �� <br />180 DAYS OF DATE PEPMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY B[ <br />CANGELLED BY THE CITY UPON AfvY STOPP,GE OF WORK ON TN�S <br />PROJECT OVER 90 DAYS DURATION. <br />