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Date__l�-�g 5 <br />PUBLIC <br />;: <br />:V. <br />qpplication Fom <br />WOI�K� <br />O <br />0 <br />� Qi <br />"��1 SaOSTING �' 1 `� �— <br />PERMiT <br />� PCJOu�70� <br />Print or Type Only n o r%, o.� o m <br />v�w�w`"«;� <br />y, w <br />RALPH SCflUCK 20717 36'�} A�E NW STANWOOD 98292 <br />A4Ailmu A�1rG5.1F�� Z 3�j l.'t: <br />Owner o oG�it�c��w <br />� pJJW fifi <br />,., ama.scnnt�i <br />•-' ------- <br />M:�i6n:; Addr.,ss <br />NEW_HOUSE – BASIC 1122_ <br />Describe Proposed 1M1brk _-- — <br />ri„ <br />� <br />/ss� = <br />Pubi��.�'JorFSP��nm�a �� <br />�mn oeoi , ---49}�Q-- -- <br />pupi¢tVoixsFco 5 --_ <br />Total Fee <br />�ess nuni F,.•. aa�e 5 — <br />e.,i.,� ��r�,,. S u%�� _ <br />652-1309 <br />z��: r�n�>�,�: <br />._--- �-- ------ <br />�ip Pirone <br />— ��/� 7—/—�— ����, P� ti c�-1��! --�-- — <br />projectAddress�ifknown; _ IIV—IL--L----- <br />Attaeh four (nl copies ol p�ans loi proPosud wurk � Draw. ta ,c.ua .�n,t nct�• tna !oiluwing as anVlicahie. <br />� Property Lines <br />• Outline and dimensions of all exi5hng cmd <br />proGoSed Slructure . on the bf <br />• �xistina and proposed utilities <br />LOT 10 <br />• Gen�?illne n� streN� <br />O P`.dicatr: Narth <br />� ci�„�:� � m r.r000sed 9radin<� changes <br />� Shr,;� maasu�ements <br />TH <br />PERMIT CONDITIONS <br />1. All calls (or inspeclion shall be made 24 hrs. in advance - Phone 259•8810. <br />2. All work shall be performed in acwrdance with this permit and current City of Everett Design and Construction <br />Standards and Specifications. <br />3. Call Loca:ion Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-80 1-424-55 . <br />d. <br />S, <br />li. <br />S. <br />K�cp c�ty �treets clean at a1l tuues. ' <br />CtuU gutter ��d si�zwalk'vi iLz plat are new a�id un��naged, any d:u��arz thereto shall ba �cp:a��d at tha <br />discretion of tlie Fublic Works L�specter. <br />Any change ui tlia �hivewaV cu� nius[ ba spproved by dre Fublic Works Lu�iector. wid�l� st prop lir�c linuted �o <br />c;�isting apron widt}i. Drivcway may taper �iaduallV to mect g�u'age door ent���u�ce (for an appi'ovc� 3 c:u' <br />N:,ra��eJ. <br />Adjust water buxes �u p7a�e al eud uf consUucliou. <br />Di�ision '_' Lots ]ots 3;1;5 K� shall disch�r�;e rooRop dr�in�;�,c to tliz lots intillration trencii as per Uie <br />„Di>persion 'IYcnch lletail" on sh.et 5 of U�e plats constnictions plans. A prrcoushucliou ineetiue, nwst bc <br />��lie�ul�d with rUa�i Locke (3SS•9G55 mob. or 259-SSIO otlice) p•ior to uistallauou of ttre u�filtratiun s}'stem. <br />.�ny ����p�t, ° ��� IDHIG'�I1011 VClll'II �11115[ IlC :Ir�1'OV:(I Iij� Uie Yublic Wor}:s Lispector. :lll otl�ei lots ui <br />Di�isiot� 2 disch,uee rooRop drauiaKz to tira sroiru drain smb provided to [1�e 1ot. T �F c�rioinoNs <br />Approved as Constructetl <br />: � <br />PUBLIC WORKS DEPARTMENT <br />3200 CedarStreet <br />Everett. WA 98201 <br />Phone:259-8810 <br />/ <br />Z <br />� <br />AGKNOWLEDGEMEN <br />The under�ianetl ovmeUaUP�'cant hereby agrees lo hold and save hann� <br />less the City of Evere�l Irom any and all claims fnr dama9es. �.osts. <br />expenses �r causes of action ihat may ans� because of installation <br />and mainlenanr.e �! �he improvemenl or other righhol-way us.� hereto <br />�p�,hni; for and fu�i��er a9rees lo remove samn upoi� �otice ��om the <br />��,!y ar,d to replaca Pub^ properry damac,ed t'�erebY. <br />�-- — W li�an! / Daie <br />Sig ature APP <br />WORY. AUTHORIZED BY Tf-IIS PERMIT MI�ST BE STARTED WITHIN <br />1A0 DAYS OF DATE PERMIT IS ISS�JED AND THEREAFTER IS TO <br />3E DILIGENTLY PURSUED TO COMPLETION. THIS PER�dIT MAY B[ <br />CANCELLtD BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJEGT OVER 90 DAYS DURATION. <br />