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Date 12/5/94 <br />Application For <br />PUBLIC WOR�CS <br />..'L <br />J.i <br />Print or Type Only <br />Ra.lph Schuck <br />qpplicant <br />Describe Pioposed Work <br />l�� <br />�": <br />15621 OP. Plill. <br />Mailing <br />�`11�i1����a�- u>a�. �,sk,.�fl��o��,vo,k=P�,m,,.��� <br />— eia9 oeo� � 46366 <br />PERM�T��J�Yi���l PublmWFee <br />ri r.i ��_� � -' O c; <br />r.] C� C'� p'� �- <br />�.} I". r' i GJ ..}� O <br />u; �r� -:, ,� •. c�i <br />L1 <br />1i1. �' �.� a.`. <br />Snohonis} <br />55 r7 _%' <br />_� -� <br />ID f�' ]- [9 _ <br />l 1!� f 1!' [ 1 �' <br />Ii <br />t�� f...� IJ (I.1 iJl f.� <br />G]uC� r,��:.: <br />p� � i q CJ L� <br />o� r=� u rr� � �. <br />�I'� VJ `l: . <br />d� if> ::� ::� � <br />�98290 <br />Less Aooi. Fee Pa�d 5 J — <br />Ci r'�iIC�aIMW:DY9 r�� r:�s L�� <br />Cl Ll �f'� <br />.` � ,.1'. �. <br />{: n m <br />? II� If1 <br />tl1 <br />33�'-0817 <br />Ci�y r`; : _ •+, <br /><.'? r^ _i r^i � <br />I I l I _J t �-� <br />� .i f ! . <br />City <br />Alew house — Basic 279 <br />'� O ..y L� �T <br />'iJ .-' : b.� N: <br />., � ,.i � : n. n . <br />Zip � "- <br />[.: �i <br />r�rr�:r�" _ <br />� i . r i r:l [. � <br />1 � I�1 .. 1 ir i�I <br />� f r _. <br />Zip <br />Prolect Address (if known) <br />� ��?� �— � 7�1 l/1"iW ___�nr 1. 112tii S_t �[a Gstate <br />At�ach four (4) copies ol plans tor proposed work - Draw to scale and note� Cen'terllne ot �Peeii able�. <br />• Properry Lines • Indicale Norih <br />• Outline and dimensions ol all exisling and p Show any proposed grading changes <br />prop.se2 structures on the lot � Show measurements <br />• Exist•ng and proposed utililies <br />Phone <br />FERMIT CONDITIONS <br />7. All calls (or inspection shall be made 24 hrs. in advance - phone 259-8810. <br />2. All work shall be performed in accordance with this permit a�d current Ciry of Everett Design and Construction <br />Standards and Specifications. <br />Call Location Underground Service 4$ hrs. before you dig. TOLL FREE NUMBER 1-800•424•5555. <br />,�' j( Y."�� fll\' ?Yr:::'.IR C�C,III 9I il�� Ilfil'.'S. <br />S. i urli euner and sidewalk in i!ie pla� are ncw �nd undamaeed, :ury da�n;���c il�creto shali be replaced at tl,c <br />di�crction of thi; Public «'oiLs Inspector. <br />F Any chan�e in Ihc dn��ew;rv cnt mnst bc approved bV �hc Public 1�dorks Tnspector. widlh at prop line <br />IiwiicJ io c,ti,liu�; apiou widlh. D�i�eway way laper �iaJu�illy tu -:i:el p;:uugc duor euliaiva ifoi ;m <br />appro�•cd 3 car g�ua,el. <br />� Adlnst wsUrr boxc, tn er;idz at and of conslnic�ion. <br />^ Lots 5 iiuu :>li,dl di,cl�arg� roollo�� �rau�aka I� tl�c stoiu� �r,wi shd, pro�'iJcd la 1►�c lo!. <br />�� Lols L du�� 4 s1iaU dischar�,c ronftop driin,;;c to ihe Int� inlil�ratior trencli as per Ihe "Dispersion Trench <br />I,eiail` on sheci � oi Ihe plais consiniciio��s ��laus. .1 prcconsm�cnmi meetin� mus� b� ,cheduled with A! <br />l.ocl:: (38S•9GsS mob. or 2�9 SSIn oliic�) piior ta inslallation of thc iiifiltration syslrm. �Uiy ch;mgc iu <br />Ihe inliltr:dion Irench must hr'ipprnvtd b�� fhe Pnblic Works [nsper.tor. <br />F�NAL INSPGCTION <br />Approved as Constructed <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Sireet <br />Everetl, WA 58201 <br />Phone:259�8810 <br />' � Date <br />_l�— � / <br />oato <br />Z <br />� <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the Gity of Everell irom any and all claims tor damages, cosls. <br />expenses, o� causes ot aclion that may arise because of installation <br />and main�enanca of the improvement or olher right-of-way use hereto <br />applied inr and furiher agrees �o remove same upon nolice Irom ihe <br />City and to replace pul�i�Property dar�✓dt�ed thereby. <br />aiynamicy�..�,N��....,., - <br />EORDAYSTOF DFTE PERMIT IScISSUED AND6THEREAFTER IS 11�0 <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERP,AIT PAAY BE <br />CANCELLED BY 1"HE CITY UPON AIJY STOP°AGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />� <br />. . . S .... � � . <br />. .. . ... . . . <br />.v_ � .� , . , . . . . . . . . �. � . 1 � . . <br />