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Date_1L],9J95 „�TO POSTII`IG C P�o���wo,k�aa,m„„ <br /> Application For,i �5 eide.oop�.. 4�� � <br /> PUBL.I� WORK� PERMIT P����=W��k=�eB -- <br /> �t :otei Fee S_ <br /> n �255Appl.F¢C Pdl� � <br /> � <br /> O <br /> Print or Type Only .r � p � � � o0 p 0 0 .-� oai,��e o�e S 7��� <br /> !` . O U Ov1 <br /> � � � � o ;� o ui ac•� � <br /> .� � wa+ � «o � � � � ,� <br /> Tennyson Homes Iuc 815 6th St S N Kirl:land �$03�' 87`/-9060 ' <br /> Owner Mailing A rCssq r� -.(��t�v p ]. '� <br /> � � � 3 c� r� �+ w � Z�P Phone <br /> T'� OO � L � C=,1N0 � O W Cs [1 <br /> I oF- 03 Ul W <br />� Same \ OJ J W J � fiORO W - S <br /> _ r•� atmr� sa� cnoa � � mFnc� <br /> Applicam Mailing Address City Zip Phone <br /> iJew house � <br /> Desc�ibe Proposed Work � I <br /> _ ' <br /> Projecrprd�ess(ifknown) 5807 12th Ave SJ Lot 64 iferrill Creek Gar-�c^.s � <br /> . Atlach four(4) copies of plans for proposed work• Draw lo scale and noce the follcwing as applicable: � <br /> • Property Lines � <br /> � • Cer�terline of street � <br /> • Outline and dimensions o(all existing and • Indicale North <br /> . proposed structures on ihe bt • Show any proposed yrading changes <br /> • Existing and proposed utilities • Show measurements <br /> DO NOT.VRITE BELOW THIS LINE '��� � <br /> PERMIT CONDITIOMS O <br /> 1.All calls for inspeclion shall 6e made 24 hrs.in advance-phone 259•8$1(). <br /> 2.All work shall he pertarmed in accordance with this permit and current City of Everett Design and Construction � <br /> Standards and Specilications. <br /> 3.Call L �ation Underground Service b hrs.before you dig.TOLL FREC- NUMBER 1•�800•424-5E�55. <br /> 1. X.cep city slraets cican at �l�tunes. � <br /> �. Curb euner and sidewalk u��he plat arc new arid undamaged, :my datnage thereto sh,ill be replaced at the <br /> d�scretion of tl�c PubGc �l'od:s L�s��cctoc O <br /> 6 hirv chane.e in the dnvewtn�cut rmist be approved by the Fublir. Wod:s ?ns;�ec�or, w�dth al ptop fiue <br /> fiie:ited fo cxisluiE�,apiuu widili. Dri�cwuy may laprr�adu�dly (o weel g:uai�e ilour cnlr:u�ec (for:m <br /> �p[!roved 3 car garagc), �� <br /> �. Adjust warer boxes to erade at end ol conslruction. � <br /> �. Ptiv�w��. shall Le complele(}� curcd bcfore Jriw�g on them. <br /> 9 RooRop draum;e shall be discharg;d ro ihe lots infiltratian trrnch as per U�e "Residenti;il hoof Downspout � <br /> Sysiem" cleiail laitached) a�id as per ihe ,iank, s�:rt locaiion in'ronnafion on die IoP, site pian. A <br /> precons�n�clinn mecting must be �chcduF�d��4tli Al';ui Loci:c (3SS-9G55 mob. or 259-3S10 officz) prior tn <br /> ir.��;;'�•lion nf Ihc intil�rafion svstom Am•cliai��e in 'he infiltration trench must he approved iry tiie Public � <br /> 1Vui:,s Lispcctu�. � <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> -- The undersigned owner/appliamt hereby agrees to hold and save harm- <br /> — less the City of Everetl from any and all claims tor damages, cosls, <br /> expenses, or causes of aclion that may arise because of installation <br /> � �^ � and maintenance of the improvement or other right�ohway use hereto <br /> ApProved for Cqnsirudion � d further agrees to remove same upon notice from ihe <br /> /(��� Date Ci d to re lace public property damaged thereby. <br /> ✓CY�� 5�/•y� / <br /> FINA� INSPECTION Date / � <br /> Approved as Consiructed Signatur of Applica t ��-- —1 Oat� <br /> 'V� PUBLIC WORKS DEPARTMENT WORK AUTH fPfD BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200CedarSt�eet 780 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett,WA 98201 BE DILIGENTLY PURSIIED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone:259�8870 CANCELLED Bl THE CITY UPON ANl"STOPPAGE OF WORK ON THIS I <br /> PROJECT OVER 90 DAYS D'JRATION. ' <br />