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Date_����5 <br />TO pOSTING z-2�-�� <br />Application For <br />PUBLIC WORKS PERMiT <br />�.,,�„<<�:�,�_�..,,�„ 9S��z� <br />�ino o�o� . 49171 _ <br />Publ¢ Works Fee <br />TOIAI Ff!C � <br />LrSSAUUI Pnr?.�',�J S <br />Print or Type Only �',""�` o`� <br />Ralph Schuck 20717 36th Ave N[d Stanwood 98292 652-1309 <br />Ownei �1a�hny qddress C�ty Zin <br />Applicant rm�i�n:;Addre;s �----G�h; ZiP —_�--- <br />Describe Froposed Work __.NOW HOu50= Old B85iC 279 _____________ _ <br />Pro�ecl Address (d known; � ��_�.4 , _�_/ T�"! <br />____ _ -,J <br />^ �ii'�.3'�i li <br />- __.:� <br />Attach four (4) coPies of plans lo� Proposed wor�: � D�av: fo ,�,�!�. ,c���.r nnte ,ha !oqo•,ving as anUlicahie: __, <br />• Property Lines � C�+nterline nf streel .. <br />• Outline and dimensions ol all exishng antl • In!Lc3ie Narih -_ <br />proposed siructures on ihe !ol • ShOv: 3ny r,reposed ywdinp ChdnJes <br />• Exisiinr� and proposed utilities • Show mrasurements -_�� <br />.S �� <br />Phqnr, <br />Phon� --_ <br />J_ J <br />UU NOI WNIIE dtLOW IHIS LINt �� - �- - <br />PERMITCONDITIONS � � <br />7. All calls lor inspection shall be made 24 hrs. in advance - phone 259•8810. � � - <br />2. All work shall be pedormed in accordancr: with this pem�it and current City of Everett Design and Construction'�. � <br />Standards and Specilications � • �-� - - <br />3. Call Lec:�tion Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800•424�5555. <br />1. heep rity streets cleaci at ;�I tinies. _' _''� `: , <br />5. Cwb �;utter a�id sidew;ilk u� We plat me new an�l midamag�d, ar�� dmnage Uiereto: sliall ba repl3ced at We <br />�iscretiun of die Public GVorks vispectm'. -- " <br />ti. .1�ry chang� ni U�e drivewat� cut mus[ Ue approvecl Uy tt�e Public Works Gispectiu, widQi at prop Ime limited I <br />c�ist'v�g apron width. Ddve.tiv.�y mTy taper gadnally to meet g;u�aroe door entrvice (!or m� a����r9ved 3 c:u <br />�•arauel. _ <br />Adjust w�der Uox; s lo Krade al cnti of wusiniclion. _.. <br />3. Ui�7siun 3 Lots lots 3;1,5 R 3 shall disch�r�;e rooftop drainate to tlre lots uifiltra6ou Vench as per_thc <br />"llispersion '1'rench llehtil" un sheet 5 ot the plats coustiuctions pi;u�s. A precauuuclion me2Qci�;hwst be <br />�chedided with zUmi Locke (33o-9G55 moU. or 259•8310 office) prior to u�sLillation�of Q�a infii!ralibu sy�icw. <br />.�Lry chan!,�e in die ¢itiltration trencl� umst be appro. ed by llm Public }Nods L�specfor. All oL�:r let� in <br />� Division 2 shall dischnree rooftop drainage to die stomi drain stuU provided to d�e lot. <br />�, AGKNOWLEDCi[MENT OF CONDITIONS <br />� �: � : <br />I <br />�� � � �� . <br />Approved for nStruction �r�-�, ��: I <br />�� Q—� ���= �� � <br />��� � U// � � <br />FINA��7SPECTION ���3 �%ilr / —� Date I <br />Approved as Constructed I <br />������� PUBLIC WORKS DEPARTMEIJT � <br />3200 Cedar Sireet I <br />Everetl, WA 98201 <br />Phone:259�8870 � <br />ihe undersiqned alener/applic2nt hcreby agrees to hold and sa��e harm� <br />less Ihe Ciry ol Everett Irom any and ail claims tor dama9es, r.osts. <br />espenses. o� causes of action thai may anse because o( insiallation <br />�nd inaintenance o! tne nnprovement or other ric�hho(�way use heieto <br />ap�,bn,! for and furiher aqrees to remove samo upon notice Irnm tlie <br />G'v �nrf to replaca pubhc pronert� damaged Ihereby. <br />Signzdwe � AppliCan! ��—l_�i Da�e <br />LNORK AUTHORIZED BY THIS PERMIT MUST BE �TARTED WITHIN <br />78p DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLI' PURSUED TD COMPLETION. THIS PERMIi �dAY BG <br />CANCELLED BY THE CITI' UFON ANY STOPPAGE GF WORK ON THIS <br />PAO.iECT OVER 90 DAYS �URAiION. <br />