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Date 1/3/95 <br />App�iCehon For <br />PUBLIC WOR�CS <br />Print or Type Only <br />� 1�1 ZvS <br />PER IT <br />'�� �STlNG <br />538�iP,SiB <br />�"��M�� <br />290-1818 <br />L 5 L Builders 10711 Evergreen Wy <br />Owner Maihng Address <br />Larry Pond <br />ApphCant <br />Describe P�oposed Work <br />Pro�ect Addrass lif knownl <br />Atldress <br />� <br />r <br />9A�4 <br />�� <br />A.PR ''� - 'S <br />Cily � �. <br />������ <br />r� i['. �! Si u�, � <br />New house - Baeic 199 <br />8 <br />� <br />M <br />Punbc Wm�e V�.mn �_ I�� V__. <br />e�ee o�o� � _4G612 ___._. <br />Pom¢ worw� Fae <br />�. Tmn vee f ___ <br />I�+s�oo�FeeFainf _ <br />�'�sp°b s � O _ <br />��;q{ <br />N�A�d <br />�c� � � � � rnone <br />2ip Phone <br />715 106th P1 SE Lot 8, Short Plat 44-90 <br />AttaCh fow 141 copies ol plens for proposed w�rk � Draw to scale and rote i ie �ollowing a5 Bpphceble. <br />• Property l.inas <br />• Oullme and dimensione ol all ensting ond <br />prOposed 81ruCiweS on �he �o� <br />• E�isting and prepased utilities <br />• Centerline ol streel <br />• Indicale Norlh <br />• Show ony propo5etl grading chen�es <br />• Show measuremenis <br />PERMI7 CONDITIONS <br />1. All calls lor Inap� clion ehall be made 2a hre. in advance � phona 259•8810. <br />2. All work ehell be peAormed In eccordance wlth Ihin Dermlt end current Ciry ot Everetl Design and C�natruclion <br />Stenderds antl Specilicetlons. <br />3. Cell Loceiion tlnderground Servlce 48 hrs. befora you dlp. TOLL FREE NUMBER �•800•424-55rJ$. <br />1. Dirt rxcnvntcd fnr laund�tioa -hn11 be rrmoved frmn �ite (unless otherwisr npproved try the pubGc w�uks <br />msprctor I �uid lieukd �o n p�muied till de,nnenmi. <br />5. I�ccp ci�� strcets elca�� at all time�. <br />6 ('nrA putter mui sidewalk m Ihr, plet ere new nnd imdamaoed nrty dmnaee thereto shell De rcplaced et fie <br />Jise�eliun ul'Ihe FuLGc Wuiks �ispecloi. <br />'. Arry chanee 6i th: �Ln•�u•iry• cut musl be spproacd by Ihe PW [nspeclor, width at prop line luiuted to ensting <br />npron width <br />S. Adju,l wulei Loxa� to tpade al euJ u( cuuslmdimi. <br />9. SiN fencns nnd'or other emsjon conhol mensurrs shnll be installed by the bu0der et the direcfion of the Pnblic <br />wort:s uispecioi. <br />I�l. Rooltop Jrainagc slmll b� di.ch�F��d os follow.;: <br />1 ots l � k R l'onnra ro fhr pinl's ctomi dmn� �,ysf�m n shih is provided e� the froni uf Ihe lot <br />(� <br />Luls l. 2. I. 5. 6 fi. Y. ('mniecl lu Ihe lol', wetivedwd Nench cLtir ,nu�idrd el Ihe row uf eu�!� lul. <br />, (Y� �l l � <br />onslructad <br />PUBLIC WORKS UEPARTMENT <br />3200 Cxder Stree1 <br />£verett, WA 98201 <br />Phona� 259�BP10 <br />('aidion: ('arc must b: tnkcn not lo di;n� H the mes of ti�c trencL �Leirt! <br />ACKNSWLEDG[MENT OF GONDITIONS <br />�o y, <br />DatP <br />� <br />� <br />� <br />� <br />O <br />� <br />� <br />O <br />a <br />The undxrsiqnnd mvne�inVPlicnnl he�eby eg�ees lo hold and save hanm <br />Irsc Ihe Cdy ol Everelt Irom qny BnC all cleims lor damaaes, r.�eis <br />expenses. or causes ol eclion thal mny erise beceuse ol Instellahon <br />and malntenanr,e ol the Improvement or other righl-o4wny use hereto <br />eppiieA for and Iwther eBrees Ie rem,ove same upon no�ice Ircm Il�e <br />Ctly anA to replace publ�c p�ape�ty demagad the�eby. <br />G}i� �/tn,.lo-,� /��—�'L� <br />Signalure o� 4pphcan Date <br />WORK A7THURIZED BV THIS PERMIT MUST BE STAqTED WITHIA'. <br />1B0 DAYS OI- DATE PERMIT IS ISSUED AND THEREAFTER IS T!J <br />BE D!LIGENTLV PUFSUFD i0 COMPLETION. THIS PERPAIi MAV FE <br />CANG[LLED BY THc CITV UPON ANV STOPPAGE OF WOFK ON T�dS <br />PROJFCT OVER 9C DAYS DURATION. <br />