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_"_—'_. -. ••r--�_._, __ . . h �. _ ,.T, _ <br />I <br />_�..._.._.._ _ ��{ <br />. -' :�. T � . ___ _ .__ .__' __. _'. _— <br />� " - 'i��'��ItY ��'A7....�T.. � �. �Y�� ���.� <br />u (� ' 2�"�'S , <br />rtn p��T�Nc_ -1 I 1`� U <br />; �:.�e�14-93 <br />Applicatlon for � <br />PUBLIC WORKS PER�AIT <br />� <br />Print or Type Only � � g� S� 8� g <br />m :��:�N'_�a' 13 <br />.� .. <br />Duane Berg 12417 36th Ave SE 6ve � t.� �� � � � �3 '-7 � �F ' <br />Ownar Maump Atldrese r%y 1 <br />Duene Berg Conet S. �' m S $ <br />Applicant <br />Mailing Address <br />Daecribe Propoaed Work nev houee Lot 17 Eleenhower Court <br />Prolect Addrese (il known� <br />� 101 <br />Puelm won� P�.mn . � / �W <br />7—'— <br />Bl�p pnPl I 4p9�,� <br />Pu>bc Y+orM Fee <br />lotelFee �___ <br />la v AppO� FH Pu0 { <br />e�6.�ofi9 • l�e''_�%~ — <br />:� <br />^ <br />Attech lour (4) copiea ol plene lor propoaed work • Drew to scale antl note the lollowing es eppllcab�e: <br />• Properly LIne6 • Centerlina of atreel <br />' • Outline end dimenelonn ol all exielinp anA • Indicate North <br />proposed atructuree o� Ihe lot • Show eny propoeed grading chenpee <br />• Fxieling end propoeetl utllitiea � Show measuremente <br />P1mne <br />PERMITCONDITIONS <br />1. All celle fo� inepectlon ehell be mada 24 hro. in advence • phone 269�8810. <br />2. All woik ehell be perlormed In eccordence wlth Ihla permlt and current Clty ol Everetl Deelpn end Conetruclion <br />3tenderde end 9peClllcallorc. <br />3. Call locetion Undarpround Service 4B hro. belore you dip. TOLL FREE NUMBER 1•800�424•56li5. <br />4. Inatai] rock ennntrur,tion antranre bnhind driveNay ae pnr city <br />etendnrd p20H and Aroeion contro] 9A (jiCP�`LBlI IN F�ib] ic Wnrke <br />Innpectnr. <br />5. Keap city etreete clean at ell timee <br />B. (�arb guttar and eldeWalk in thr p]at are new and ixndamaged, <br />eny dnmagn thereto ehall be replaced at the diacrAt.ion �f tha <br />Puhlic Workn inepr.rtnr. <br />7. Any chanQe in the drivewey r_ut munt be npproved by the PW In <br />epactor, uidth et prop line limited to exieting apron Width. <br />9. Conner,t nl] roof, yard and driveWay draine to etoevn drain <br />ayetem provided to lot. <br />9. pd,iuet Weter boxee to grade at end of conntniction. <br />10. Driveaaye nhell be completely r.ured Fx�fore drivinq cn t,ham. <br />�I <br />App�oved ee Conetructed ' <br />�PUBLIC WORK3 DEPARTMENT <br />3200 Cedar 9treet <br />Everett, WA 98201 <br />Phone:259�BB10 <br />�6 y3 <br />Date <br />W <br />� <br />� <br />� <br />O <br />� <br />� <br />O <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The underslgned owner/eDPlican� hereby agrees to hold and save herm� <br />lass Ihe Cdy of Everett Irom eny and all clalms lor demages. cosls. <br />e�penses, or ceuaea of eclion that mey erlse beceuse ol instellalion <br />end mainlenence of the Improvement or other rightrohwey use hereto <br />applied lor end lu�the� agrees lo remove same upon notice Irom Ihe <br />City and to replece pubhc property demaged Ihe�eby. <br />/ ` <br />� �� , �t <br />etura ol Applicanl� Dale <br />WORK AUTHORIZED BV TFIIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLV PUFSUED 10 COMPLETION. THIS PERMIT MAY BE <br />f;ANCELLEO BY THE CITY UPON ANV STOPPAOE OF WOHK ON THIS <br />PROJECT OVER 90 DAVS DUpATION. <br />