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Date <br />10/2/95 <br />PUBLf� <br />ApP!icatibY For <br />W01'¢�.S <br />Op <br />b <br />Print or Type Only <br />RALPH SCHUCK 2071 <br />O�vnei <br />� � v/ �, <br />Ta �osti�G .�—�- <br />PERIVIIT <br />Q O O � P � <br />uir;o.ior„ <br />L M � � � `V <br />AVE NW � STAN[d00D 98292 <br />a��.;lolr�,s x x � [� <br />.�+ nor�c�r� w <br />o �4 fi=U)o V <br />Applieanl Df.,�li�� ; �ddress <br />Ciiy <br />DescribeProPosedWork _ NEW_HOUSE_=BASIC 1105___ <br />PUULc YYorks Pnrmil + _�[-� I—/�� �—� <br />Bi<19 Dept a ._�----�I((1•� -- <br />p��plic Wo�ks Fee S <br />.�„� F�� <br />Less <onl Fno P,vtl S <br />pn�ann� Due S � <br />652-1309 <br />jip Phonr. <br />Zip _—_ Phone -- -..__ <br />ProlectAddrzssldknown! _J...'—O� ���1 `—I-�r-�-G�_\-`--------�--- — -- LOT_9__ <br />Att2ch four 1�11 copies ot plans fo� G"oP���`d wo�k � Diav. <br />• P�onerty Lines <br />• Outiine and dimensions ol ail existmy and <br />proposed strucWres on ihe lot <br />• Existing and proposed utihties <br />to .e.:L..u,a nc!c ;ha followmg as apVlioabir. <br />• Cen�erline nt SVeeI <br />Y Indicale Nor�h <br />• Show any r.roposed 9raC�nn ahan�_n•s <br />• Shov: mrasurements <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hrs. in advance - phone 259•8810. <br />2. All work shall be performed in accordance with ihis permit and current City of Everett Design and Construction <br />Standards and Specifications. <br />3. Call Location Underground Service 43 hrs. before you c'g. TOLL FREE NUM116lR 1-800-424-5555. <br />a. Keep citt� streets ci�an at <ill lunes. <br />5. Ciu�b �titter a��d sidawai� ui Uia pint a��a u�sr aiid �md,un:;g�d. :iiry �awag� ilr�r�:o iiall b� rcplacad at Uie <br />discretion of tl�e FubSc lUmkr Lisp�ctor. <br />�. ,itry chanQe u� the dnveway' cnt nur�t be approved by tlt� Fublic �L'orks Lispec[or, wid11� st prop luie lututed « <br />c�sting apron w�dtl�. Diive�a�,!y m�V taper c�r�dualtv to mect ga�'a<.�e door enua�uc (for a�t approv�d 3 cti' <br />�•arns�e). <br />'. ,Idjusl waler boxes to t�ade �t :ud uf couslwcUou. <br />3. Di��sion 2 Lots lots 3.•1,5 �f. ° sha(l dischsr�;e rooltop dr�ina�e to th� :ole infiltrelion Ireuch as per the <br />"1)ispersiou'I'rench Detail" ou sl�ret S ol tlie plats coustn�cGous plans. �t preconsWctioi� meetin� must be <br />=eimdi�zd w�ith Al��i Locl:e (3SSAG55 moU. or 259-SS10 office) piior to uist�llation of tlie uitildation systc�n. <br />tnp chan��r in die u�tiltration trench must be approved by die Fublic Nlork5lnspector. .AII etl�et' lots in <br />i+ivisiou 2 shall discliaree rooftop c6 aina�� to tl�e stonn drtin >nib t�rovidad to ihe lot. <br />A1`��I�o (�! � <br />—___ __ _ . .I <br />Approved as GonstruaeU <br />4� <br />y <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Sireet <br />Everetl, WA 98201 <br />Phone:259�8810 <br />ACKNOWLEDGGMENT OF CONDITIONS <br />fa <br />� <br />Th� undersianed ovmeUapGhC2nt hereby agrees �0 hold and sa��e r�.rum� <br />iess Ihe Ciry of Everett hom any and atl claims for �fam.iges. �.�sts. <br />e�penses. or causes ol action that may arise because of insialC:!�.en <br />and mainlenanr,e �! lhn improvemenl or o�he� righbot-way use her«,to <br />,�^pi�nC for and further aqrees lo remove same upon notice hom V��� <br />C.t• ,:rd Io replac? nuU : pronerry damaged thereby. <br />i <br />Si9natwe AnPhwn! Date <br />�.NORY. A:;TIIORIZED B'i TFIIS PERMI7 MUST BE STARTED WITHIN <br />t80 DAYS OF DATE PLR�-11T IS ISSUED AND THEREAFTEH IS TO <br />BE DILIGENTLI' PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLtD BY TNE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PPOJEGT OVER 90 DAYS DURATION. <br />