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Date_1/24/90 <br />Ppplicatinn For <br />Pu��ic vv�r�Ks ���nn�r <br />Print or Type Only <br />Select HOmes P.O. Box. 708 <br />Owner <br />Same <br />nt <br />Pfukilteo, L7A 96275 <br />Mailinc� Address <br />827-819G <br />City — <br />City <br />Zip <br />nuolic Ym�hs P �, �C� � ,�j !4, <br />� mn v <br />eieo. oeo�. • 90/23604 <br />PubLc Works Fee <br />Totol Fec 5 <br />l�-:sApPl.FcePa��d � <br />BaianceDuc $ 'Z�' <br />Describe Preposec'. work _'�ew single fami�y residtnce, Lot 17, Glenhaven Heiqnts <br />Prolect Address lif known) <br />� LJE`_;� <br />Attach lour (4) copies of plans lor proposed work - Draw to scale and note the following as applicable: <br />• Properry Lines <br />• Outline and dimensions oi all existing antl <br />proposed structures on the lot <br />Y Existing and propored utilities <br />• Cen�erline ol street <br />• Indicale North <br />• Show any proposed grading chan�es <br />• Show measurements <br />NOT'NRITE BELUW <br />Phone <br />Phcne <br />°ERMIT CONDITIONS <br />1. All calls for inspection snall he made 24 hrs. in advance - phone 259•8810. <br />2. All work shall be pedormed in accordance with this permit and current City ot Eve ��,i Design and Construction <br />Standards and Specifications. <br />3. Call Locaticn Underyround Service 48 hrs. betore you dig. TOLL FREE NUMBER 1-800•424-5555. <br />4.ANY CHANGE IN THG DRIVEWAY C[JT MUST BG �'PROVGD <br />BY THE PUBLIC WORKS INSPECTOft. <br />5.CON@]SCT DOWNSPOUTS TO `rvnrrai�o'T'�'iiD Ln[�y-"��„ "iLIG p�A�Mce6�-��75'�C-M <br />6.REEP CITY STRGETS CLEAN AT ALL TIME;. <br />7.ANY DAMAGL+ TO Ti{E CURB AND SIDEWALR �IILI s REPAIRED <br />TO THE SATISC+F.C".'IO!•i OF THG FOBGIC W0.<<,5 ';'. <br />�;�'�w� � ``�-� z / L /`x% <br />Approved lor Cor�strur iop� Da�e <br />/ , <br />_.���j�/! ��� -���-�G _ <br />FINAL INSPECTION D2te <br />Approved as Constructed <br />everett PUBUC WORKS DEPARTMEJT <br />� 3200 Cedar Street <br />Evereit, WA 98207 <br />Phone:259�8810 <br />ACKNOINLEOGEMENT OF CONDITIONS <br />f�i <br />V <br />The undersigned owner/applicant hereby a4�ee� to hcld �rJ save hruni� <br />Iess Ihe City of Everett from any and all cla�ms for ie a�es, rosls. <br />expe.nses, or causes of action that may arise because � installation <br />dnd maintenance of �hc improvement or o�her nght-of-way use hereto <br />applied for and iurlher agrees to remove same upon notice from thn <br />City �hd to replace ublic proper damaged thereby. <br />��'�;� ������ �f�C, <br />i � <br />! . � CC <br />Sic�n �ur o 4np!icant O.�le <br />WORK AUTNORIZED Y THIS PEflMIT MUST BE STFi+'EU �A/ITHIN <br />180 DAYS OF i�qTE PERMIT IS ISSUED AND THER[���FiEH IS TO <br />BE DILIGENTL'f i'UPSUED TO COMPLETION. THIS PEF'-0IT MAY BE <br />CANC[LLED Bl' TfiE CITY UPON 4NY STOPPAGE OF WOFK ON THIS <br />PROJEGT OVER 90 DAl'S Dl!RATION. <br />