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Date���� <br />Applicetlon For <br />PUBLIC WORKS PERMIT <br />�rint or Type Only <br />t� <br />Uwner <br />S a rri e <br />Applicent <br />Deecrlbe ProposeA Work <br />Pro�ecl Addrean Iil known� <br />'. I,�� l7oi� �� t� <br />Melilny Add�asa Clty <br />Melling Addreas City <br />S F /� <br />C <br />'�P <br />vuencN'ort�Pe.mnr ���1 --7� �' <br />au n � .i S�__ <br />Bi Da � �� _� <br />PuOnt Worh� i�e <br />To1�IFea �����— <br />Le0 �OPI. i!� P�iU { ^� <br />B�i�nce Du� i L� � nA <br />.3n� - �o�'`'� P�, �s'`�=— <br />AltaCh bur (4) copiae ol plans fa proposed work � Drew lo scele and note the lollowing es epphc��bh � <br />• Property Lfnae • Cantarline ol streel <br />• Outline •nd dimeneiona ol all eKieting anA • Indicate North <br />proposed ilructuree on Iha lot • Show eny proposed ��rading chanpr�s <br />• Exicling nnd proposed utllllies • Shovi messurements <br />is �5 36.� �v,3/G <br />Phone <br />Phona <br />PERMIT CONDITION� <br />�. All ce116 for inspection shall be mede 24 hrs m ndvenca � ph�,. ,, 259•881 5 <br />2 All work 9hell be per�ormed in eCr.ordance wilh ihie permi� entl turrenl City o� Everell Design AnA Conetructiun <br />Stendards end Specilicellons. <br />3, Cell Locatlun Underground Service 4B hrs. helore you dig. TOLL FREE NUMBER 1•800•424•8555. <br />4 <br />5. <br />Existing sidewalks are unbroken and in new condition, the applicant <br />is required to replace nny sidewalh damagea during construction. <br />Roof down spouts are to be tight-lined to existing curb drains. <br />6. Any grading of the lot is to be done so a� not to impact tlie surro�mding <br />lots with rain-water run-uff. <br />` t i / : i�.', . s� ` <br />._ _—< < �r Y � C' /y <br />Approvetl I r Constructioo U e <br />� <br />L-4-�o <br />�INAL W ECTION Dn�e <br />\pproved ec Conslrucled <br />pypfPtl PUBIIC WORKS DEPARTAIENT <br />� 3200 Ceder Slreel <br />Everett. WA 9A201 <br />Phone�.2.59-8815 <br />W <br />� <br />� <br />� <br />O <br />� <br />� <br />� <br />a <br />�CKNUWLFOGEfAENT OF CONDITIONS <br />The unde�signnrf owneUapphcnnl hereUy ngrePs lo holA and save h;vm� <br />less ihe Cily ol Everett Irom any end ell cleims lor Aania9rr. ;�.��sls. <br />ezpen��c. .: ^' ve9 0l ectiOn Ihet m-� ense becau�c oi inslall3lion <br />Bnd maln�ennnce oi .ha improvement o� othnr r�,�nru�-wey use hereto <br />epphetl lor nnd lurlher agrees to remove same upon noticc Irom Ihe <br />City and lo replace public /pro�p/eJrry damegeA Ihe�eby <br />/ , / / J <br />..� ' ' <br />_ �� ,L i� ��-�-��--_ <br />Signa�ure ol Apphr.enl Dele <br />WORK AUTHORIZED BV THIS PEFMIT MUST BE STARTED WITHIN <br />1Hfi UAVS OF DATE PEFMIT IS ISSUED AND THEREAI-TER IS TO <br />BE OILIGENTLV PUR�UED TO COMPLETION. THIS PERfdIT MAV BE <br />GANGELLED BY THE CITV UPON ANY STOPPAGE OF WC�RK ON THIS <br />PRO.IECT OVER 90 DAVS pUHATION <br />