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�/ ' .� I '�'°, "S cJG�z�b , <br /> 6�22�)2 v�ei��wonsc�.,���a. --. <br /> Date o,ag o�,,, . 37101 _- <br /> y � Applica�ion For __ <br /> d7 VuL1�cYJa�k;Feo � <br /> b � PUBLIC WORiCS PERMiT ,a�,���� � <br /> pq lussAoO� FcePa�U 5 �7 <br /> N 5 / � I <br /> pai�nec D�e <br /> o � � Print or Type Only TO POSTING__ ����Z— <br /> ro � ro <br /> y M <br /> `� � � Faixmont Homes 21902 38th Av�� [d Brie QR�"�� '�Sfi-�L�S <br /> p ---�-- Mailing Address Citp �iP Phone � <br /> O y Owner <br /> %f (p�p �p{pyy <br /> 6~'1 • � BOU CanaR � Phone i <br /> � N qppliean� Mailin�Address ���Y Z�P � . <br /> H 1 <br /> ~ New sfr - <br /> N � <br /> S � Describe Proposed Work <br /> f] O N <br /> � � � ' I <br /> N <br /> � y W � <br /> I.- � <br /> Proj�ctAddressli(4nown� � �7 � ��T� f��—' S� Lot 4, BlaCk Fc�test I <br /> �� I <br /> Attach lour(4)cop�es of plans for i�roposed work-Draw to scale and note the lollowing as applicable: � <br /> • property Lines • Centerline of street � <br /> • Indicate Norih <br /> • Outline and dimensions of all eaisting and � Show any proposed gradlnc�cY,2nges <br /> proposed strudures cn the Ict � Show mcasurements M � <br /> • Eaisting and proposed ulilities W <br /> DO NOT WRITE BELOW THIS LIIJE O I <br /> PERMIT CONDITIONS � <br /> _` 1.All calis for inspection shall be made 24 hrs.in advance-phone 259•$810. , <br /> i��\� 2.All work shall be pedormed in accordance wilh ihis permit and rorrent C:ity of Everetl Desigc and Consl��ction i <br /> Standards and Specificalions. � <br /> 3.Call l.ocation UnAerground Service 4R hrs.6etore you dig.TOLL FHEE NUMBER 1•8U0-424•5555. <br /> � 4_ Innt,all rncl; r,nn,trnct,i��n entranr.e haii.nd r�iriveway as r?er r.;tv i <br /> ste�ndard tt208 an�9 ernsir�n cnnt�r�l a� directerl hv Publir_ G7ork� � <br /> '�� I nspPct:r�r. <br /> , ��� 5_ K��ep ri.tv �at,ree.ts c;lean at all times � <br /> 6_ C'.urh F'�ltter and sidewalk in thF plat are n-rw anrl iindamaE��1, <br /> i anY dama�e t.hFrcP,n shalL he rFplar.ed at, the disr_retion of t;he � <br /> Yulilic Works InSpectric. <br /> ` �� %. Am� rhanee i:n the drivewaY cut imut be apprnved hv thr F'4: ln- O <br /> � sper.tor. wir'.i:h at prnp linF: limit.Fd to Fxistine aprun width. <br /> � f3. rnnnrct ail rr�of., yard and drivewav drairis r,o s'tui^m dra.in � <br /> �_ �psi;em provided t,�� ]nt. <br /> ', �' � 9. Ad.iust. wat-r.r hn;:a=. tn er%+dr- at enrl �f cnnstruction. <br /> � <br /> tii. DrivFwav� �h,-�11 h.� cr�mz�lr*r•lv c��re•d Fiefore drivine on t+ �,m. <br /> � <br /> q '� ACKNOWLEDGEMENT OF CONDITIONS <br /> Is� � ;` The undersi9ned owner/applicanl heieby agrees lo holJ and save harm� <br /> � less the Cdy ot Everett from any and all claim:: for damac�es. costs, <br /> � ��'AAA /— ///''' ezpenses. or cawes of action that may nrise because ol inslallztion <br /> � rY/� �/ ���—�7 - and mainte nce ol ihe improvement or other righFof�way use hereto <br /> � /// � u� V applied I r d �urther a9rees to remave same upon notice irom ihe <br /> ��i� q p p r o v e d f o r C�r�i c t i o n ���e .City an o r p�ace public proPerry damaged lhere! y. <br /> �x %6 •01� ' /�`L � <br /> FINAL INSPECTION �`�� Date <br /> �g pPlicant I <br /> qppmved as Constructed <br /> WO UT FIZE:7 8Y THIS PERMIT MUST BE STARTED WITHIN <br /> �Ir� PUBLICWORKSCEPARTMENT 160 DA �S OF DATE PERMIT IS ISSUED AN� THLREAFTER IS TO <br /> 3200GedarSlreei �E DILIGENTLY PIIRSUED TO COMPLETIOI�. THiS PERMIT MAY BE <br /> � Evere�t,WA 98201 CANCELLED BY Th1E CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259�887G PROJECT OVER 90 DAYS DURATION. <br /> ' I <br /> I <br /> i <br /> � <br />