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� <br /> Date 1-12-95 a�oi�vm�kaao,m�i• —� <br /> . emy.oeo��+ 46728 _ <br /> � Appiication For �n __ <br /> PUBLl� WQRKS PF��I��N� _8- 2� �9� PubbcYlorkSFec 5 <br /> 7Mnl Fao <br /> 0 less ApOI Fee Pab S—�/j <br /> � � O � G CJ O O G C ��^'-e Oue $ • ��-- ', � <br /> Print or Type Only ;� o o a =: v: c, n n , <br /> � o � ood� o u7or„ u�a < <br /> 'a o� m � ,, u� ci or ,00 <br /> � .n .» +,* w � aa {p. ri -�. <br /> m <br /> Steven Bartlow Cunst 3711 122nd P1 SE I•�°3�crett 98208 rr3.'37-9079"' <br /> Owner <br /> Ma��ing Address o�-��— �'�� � � o � Z� � Phone <br /> � O (�� .0 Z � S > O LL I 0 L� <br /> p .� Cu :_i � UHO F- 3 UJ W <br /> � O JJLLIJfi_' ft0 d W �� S � i <br /> Oconer [V � [JO T_ fil [n0 � 3 � � V \ <br /> f� Zip Phone ' <br /> Applicant Mailing Address Cily \ � <br /> Des�ribe Proposed Work new ltouse - <br /> W <br /> 5825 12th Ave W Lot 61 Merrill Creek Gardens � <br /> Prolect Address(it known) — -- <br /> � <br /> l.ttach four(4) copies of plans ior proposed�vork� Drav� to scale anA ❑ote the following as applicable: � <br /> ! Property Lines 8 Genlerline of slreet <br /> 9 Outline and dimensions ol all existing and • Indicate Norlh <br /> proposed strucWres on the lot • Show any proposed grading changes <br /> • Existing and proposed utilities • Sho�.v measuremenis � <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS � <br /> 1.All calls for inspection shall be made 24 hrs.in advance-phone 259•Sa 1 O. <br /> 2.All work shall be pedormed in accordance wilh this permit and curreni City of Everett Design and Construc�ion <br /> Standards and Specilications. � <br /> 3 Call LoCation Underground Service q$hrs.belore you dig.TOLL FREE NUMBER 1-800•424-5555. <br /> I' F_�•r.n ftly c1C�2fS C�:�811 1f 811 nmes. <br /> °. t.ur[� eurier and sidewalk oi tiie pla� are new ancl undama�ed, any dmna;e thereto shall be replaced at thc � <br /> :liscrztiou o(tlr Public \l'otl;s Ui�pcclor. <br /> 6 ;\rrv chaner.in fl�e dnveway cnl musl hr, approved bt>Ihe Fublic Works Tnspcctor. width at prop line <br /> limitcJ io c;cisliu� e�IIVII W'IlI(II. DIIVCW,ry maY Iapot �Jadually iu urocl gar.���c Jour .u�rauec (lur an � <br /> :1�)r7C0V".(I .S l'8f^'51�8°C�. � <br /> Adjust tvater boxes to e7ade ,d end ot consiniction. <br /> �. D�iveway� �hall bc comp(ctcly cund bc(orc Jriv��g on llr:w. � <br /> 9. Roottop draiv;��e shall be di�charecd to tlie lnts inlillr�tion uench a�. per thc "Re�iden�i'd Roof DnuRispeut <br /> Svscem" dciail laaachedl ancl as per�h� Si�r,� �nd locaiion inionnaiion on fliz lo['s siic plan. �i � <br /> pr;cons�nicliou mcclin�;rnu,t bc sclicdulcd �nith�U.�n Locl;e G;S�-9f 55 mob. or�59-BSIn oRicc) p�ior Io <br /> insrdlation nFfhe intiltrafinn systea�. ,tiry c'nan!�e in the intiltration trench must be appxoved by the Pnblic <br /> 16'o�l.s 6ispcd:n. <br /> ACKNOWLEDGEMENT OF COND1710NS <br /> The undersigned owneUapplicant hereby agrees ic hold and save harm- <br /> --- less the Ciry of Everett from any and all cicims. for damac�es, costs, <br /> ��'tL"`� - ' " �G/� �/�� e%Penses. or causes of aclio� that maY arise because of installation <br /> and maintenance of the improvement or other right-of-way use hereto <br /> applied for and furlher agrees to remov2 s�rne upon notice from the <br /> Approved �or Construction a1e — City and to repl ce pu lic properry damaged lhereby. <br /> /// "' ��S <br /> l�l/�p�� «�_ ln ' .� 3- j J' '� <br /> �`'' Date <br /> FINAL INSPECTION � ignature oh pplicanl Date <br /> Approvetl as Cocstructed <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTEG WITHI <br /> PUBIICWORKSDEPARTMENT ig0 DAYS OF DATE PEHMIT IS ISSUED AND T H E R E A F T E R I S TO <br /> 3200CedarStreet BE UILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Everetl,WA98201 CANCELLED BY THE CITY UPON ANV STOPPAGE OF WORK ON THIS <br /> Phone:259�8810 PROJECT OVER 90 DAYS DURATION. <br /> :�a <br />