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1/I1/94 <br />Date___ <br />PUBLIC <br />Print or Type Only <br />Owner <br />De9Cribe PropoSed Work <br />31 C_ZO_�s>' `.� <br />Appllcetio�t�o� <br />WOR�S <br />� <br />� <br />� <br />� <br />PEI�MIT <br />TC PQSTING _s"�� <br />C� O � L�aience0�n S �_� <br />M <br />��� <br />M <br />.,x�4n �a�-t�a4 <br />Lp Phone <br />��� <br />H 000In0 O <br />���«�P � <br />dr SK SnohrndRah <br />��������� <br />Maihng Address <br />New l�ou�;e — Basic 241 <br />� I��l�- _' <br />o�oi�c Wo��e vn�mn . <br />aia� o.o� . 432U4 _ <br />ianuc wo�a r�e <br />Tnutfee f <br />�e oo��..P.� s <br />:iry Zip <br />Prolect Address PI knownl 2426 •�sk. Sfi'�t S� Lot 14 EieenhoweC W __ <br />Attach lour �A� Copies 01 plens for prap05ed wark <br />• Properry Lines <br />• Outline and dimensions ol all exisir <br />proposed c�ruClu�aS on Ihe lol <br />• EKlsti�ig and Gr�p�sed utildies <br />Drnw ir scale and no�e me lollowing as apphco6le <br />e antl <br />• Cenlerlinn ol 5lreet <br />• Indicete North <br />• Show eny proposed g�ediny c ianges <br />� Sh�w measuremenis <br />PERMIT CONDITIONS <br />1. All cells for Inspecnon ehall be mede 24 hre. in adven�:e • phone 259-881 O. <br />2. All work ahall ta pedonned in eccordence with thla permit end cwrent Ciry of Everelt Deelgn nnd Conetrucllon <br />Standerdr. and Speci�icetions. <br />3. Cell Locntion Underpround Service 4B hrs. belore you Aig. TOLL FREE NUMBER 1•800•424•5555. <br />4. Instal rock constructlon eMnnce behind drive�wy ae per cBy <br />cte�dard A�208 end erosion coMrol as directed by Publc Wo�ks <br />knpector. <br />5. Keep city stroets cban at al times <br />8. Curb gutter md aldewak in the plat are new end undamaged, <br />any damage thereto shal be replaced at the diecretlon of Ihe <br />Publc Worlcs Impector. <br />7. Any change in the driveway cut muct be approved by the PW In- <br />cpec!nr, width at prop Ine Imfled to erlsling ap� on widlh. <br />8. Connect al roof, yard and drive�wy dralr� to s,orm drain <br />system provided lo bt. <br />9. AdJust water bozec to qrade at end of construction. <br />10. DrNe�wya ahal be compbleF,l cured before drhring on them. <br />--�'��� ' -- -- <br />�i,�L�JJ�(c:�c,— /— �3—�i9 <br />Approv � Gonstryction „ Date <br />� /� <br />� �ti <br />NAL iNS�ECTI Dale. <br />Appioved es Construcled <br />' PUBLIC WORKS OEPAFTME�IT <br />3200 Cede� Sireel <br />Everetl. Wt� 982ot <br />Phore�. 259�BB10 <br />ACKNOWLEDGEMENT OF CONDITIOHS <br />W <br />� <br />� <br />� <br />O <br />� <br />� <br />0 <br />a <br />The undar5igneA owneVapphcanl hereby aprees to holA and s�ve hnrnr <br />less the City o� Everell Irom any and all claims lor damagos. cosls <br />e�penses. or canses of action thal may erise beceuse ol installetion <br />and meintenanr.e ol ihe improvamen� or olher righl�obwey use herelo <br />:.ppl�ed for and lurther pgrees to remove snme upon notice Iro�n Ihe <br />Cily and to replace public p�operty damagetl thereby <br />� %74i-�.�� Q - b' - 9 S/ <br />Siynature ol Applicant ���e <br />WORK AUTHORIZEU BY THIS PERMI7 MUuT BE STARTF_D WIThiIN <br />1B0 DAVS OF DATE PERtil1T IS ISSUED AND THEREAFTER IS TO <br />BE CIUGE..TLV PURSUEU !O COMPLEiION. THIS PFRMIT MAV BE <br />CANCc`LLED BY iHE CITV UPqN ANY STOPPAGE 7F WORK ON TH!S <br />PROJFCT OVER 90 DAVS DURAiION. <br />