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Applicntion (or <br />PUBL.IC WORKS PERMOT <br />Print or T'ype Only <br />Owner <br />Addrrss <br />Gly <br />982 <br />Hil�nr Wnnf Parm�i ( �� � �`� � ) <br />Nma oeoi � �� <br />J��� <br />Puel¢ Wor4� Fee — — <br />tolelFee S <br />�e�e �oo� �ee Pna 6 <br />9eienrn Oue i z �%—�-- <br />J 5 D Buildera_ _ 1q29 Broadway �Uerett 98201 <br />Anpiicenl Ma:ling AGdress ���Y - Zi� <br />252-1166 <br />252-1166 <br />Dascribe Proposed Work NeW Sin le Fam11 Reeld8nC8 <br />Lot 4 - Mccill Manor — <br />Pro�ect AJJress pl known) _ ll4 – 97th P18Ce S. E. �rExett <br />Attech loin (4) copies o� plens lor p�oposod work � Draw to gc�le anA nole the lollowing as xpPlicable <br />• Properly Linas • Cenlerline ol streel <br />• OWllna and dimansions oi all exisli��g enrl • Inmcate North <br />propo9eU sirur,�ures on �he'ot • Show nny proposed U��dinq Uiany��s <br />• EMislln� end proposed u�ililie : • Show mea5uremenls <br />LI <br />Pf FMIT CUr�DITIUNo <br />I. nll cnlls lor mspect�on shell be mae; 24 hrs in advance � phone 259•8815 <br />2 4II work shxll be pe�lormed in aa.orn.�nce wilh this permit pnd currpn� Ctly oi Ever�+It Des�9n and Construclian <br />Slanda�ds end Speciflcations. <br />3 Call Loca6on Undurground Service 48 h�s. belore you dig TOLL FREE NUMBER �•800•424•5555. <br />4. ANY GRADING DONE ON THIS LGT SHALL BE L.NE SO AS NOT TO IMPACT I'HE <br />SURROUN!IING LOTS WITH RAINWATER RUNOFF. <br />5. ANY CURB & GUTTEF. OR SIDEWALK L4MAGED DUh�NC� CONSI'RUCTION SNALL BE <br />REPLACED BY THE APPLICANT. <br />/ ' //� . <br />/ G !O/!.�'�-^.� r� l ��; <br />Approved lor Conslruction A�e <br />FINAL iNSPE�N ��7� � �7 <br />ANP�oved es Construct��� Dale <br />�evrrett PUBLIC WORKS DEPAfiTMENT <br />3200 Ceder Slieel <br />Everelt WA 98201 <br />`Y Phone:759�8815 <br />ACKNOWLEUGEMEN7 OF CONUITIONS <br />W <br />� <br />s <br />� <br />Thr unde�isignc�f uv: ner/app6Can� hernby ng.ees to hold and snvr herm� <br />Inss the l:ity nl Fvn.wfl Irom any qnA qll clAimS lor �amages. �.usi9, <br />enpen�e�s. or cnuses o� e��.lion thxl mny anse beceuse ol mstallatwn <br />and ��aintenance o� Ihe mprovemenl or other righl�ol�wa� use hprelo <br />epplied lor antl furlher .ag•ees to remove seme upon noLcc nam IhN <br />Clly and to replar.e pubnc pioperly damaged thereby <br />i� <br />��r= C� �,• % .� � "�: <br />Signature of App6cant �P <br />WORK AUTHORIZED BV THIS PERN,�T A1UST BF STARTED WITHIN <br />180 DAVS OF DATE PERMIT IS ISSU'D AND iNEREAfTER IS Tp <br />BE DILIGENTLY PURSUEO 70 COMPLE'1011 THIS PERMIT MAV BE <br />CANCELIED BV THE CITY UpON ANV 5T0?PA(iE OF 4VORK ON TNIS <br />PROJECT OVER 90 DAYS DURATION. <br />