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Date 1�-1�-94 rj cj _ ��, P�o�,�wo,..r..m,�. _� l� <br /> Appllcahon For ` � ^��" (�� `� — Bma Dao� . 46220 _ <br /> PUBLIC WORKS PEF�MIT °°°°�W°��.F°. --- <br /> Te�,�«, : <br /> � ie�e�on� �•e v��a f <br /> r.� �-- <br /> Print or Type OnIY , ; �I ;' Fi ir� r� �� �_. �9�an� p�. s lXl _ <br /> i�� l�i . � C] r� mf CJ L� f:� r � <br /> ! �� ? f. . M ( : f'� f <br /> ll] in M M N � .n O �'� r i <br /> ll M <br /> Moe Homes 13314 47th P1 SW Mukilteo�98275 743-34� � ' <br /> -- O�vner Malling Atldress r"�i �. .� Gly c-� _� n} ei��p i�i �. Phone <br /> �1l �J !!1 !:I 1. ['l �� i f] Ir'f)111 �l �1 (_.I <br /> Owner z• � , r i l.� � U 1 -U:T (n �I� Li <br /> � � J I �i � r'� Q[�4I <br /> C 1 �[ � � � fi' I�i Yt 3'SPII� tll 1'i• i <br /> Apphcent MelhngPtldress Gy 2ip Phone <br /> Deecribe Proposed Work new 17ouee <br /> —.__._ � <br /> Projac�Add�ess�il knownl _ 623 107th Pl SE __ Lo[ 3 Kath �s Addn � <br /> Attach four 141 copieg o� plens lo�proposed work� Drew lo scale and nole tne lollowing ae applicable- � <br /> • Properly Lines • Centerlinr, of street � <br /> • Outline end d�mensions ol ell e.�sling and • Indicate Norlh <br /> proposed sirdr.tures on fhe lot • Show any p�oposed gretlmg changes <br /> • Eeis�ing and proposed utllihes � Show maasuremenls � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS O <br /> 1.All celle lor inspacllon ahell be mads 24 hra.in edven�e-ph�ne 259•8810. � <br /> 2.All work ehell be peAormed In eccordence wllh Ihle permit end current Cify ol Eve�ett Oesign end Corstruclion <br /> Stenderda and Specilicetions. <br /> 3.Cell Locetion Underg�ound Service 4B hrs.belore you dig.TOLL FREE NUMBER 1•$00•424•$655. � <br /> 4 Install rock consUuchon rnhencr belunA d�rvewey n� pri crty slmidazd H2ntt end rrnsion conhol a� ihrecled b O <br /> Fub�i� Wuih, Iu,ye�lot. <br /> S. Kcep nry sYeets clr�n nt nll timrs. <br /> fr. (:IIfII eUqO� 911d SI(ItWHIIC Ifl Illt �IBt 81C IICW Alld UIIII8I118�01I, 81ry (Ifl01APt IIICfCtO tiI18II I1C I�C�lIBCCfI 81 :IIC � <br /> discic�iou of Ihc 1'ublic �l'uiks hisprclo�. <br /> ' Am� ch�nae in fhe dm�rwav cut mnct t�e nppmved h}•the F'W Insprrtnr width at prnp line limited Io e�i:Hn� � <br /> apiou widtli- O <br /> 3 .ldjusi .catcr boxc� to �;radc at end of constniction. <br /> 9 Umewms sliall hr cnmplrlrly cmrd belore dmv�e on Iheoi � <br /> lu. Ruollup iLwuu{�e ,hall Le iGsdi;ugeJ. <br /> . io lhe �itr's stonn drn�i ry^tem ipm•nrc or public) <br /> . �o s residennel roof downspout �y,tem dasipued pei stcnon 4-9.4 0l ihe ci�y siandnrds <br /> . onto splash bloc4,; <br /> CKNOW EDGEMENT OF CONDIiIONS <br /> � 'i'he mefhod celrctrd will he suhjert tn Puhlir Workc f�r�rnrtemenPn��rovnf <br /> � �//r7�� _ The uidersigiie,d neuappGcenl hereby agrees lo hold anA save hann- <br /> { less Ihe C�ly ol Everetl hom any pnd all cleims fur Aamages. cosls <br /> / / rxpenses. o• causes ol nr.tion �hat may arise because of inalallalion <br /> � 8 and m�intenanr.e o! the improvemenl or other nghPobwey u9e herplo <br /> epphed fo� end lurthe� ngreas lo remove same upon no�ica hom tne <br /> .4n Const�n i J �/ Da/te. Cdy and to reF��ce publ�c pronerty dameged thereby <br /> �C'� <br /> , <br /> / �/ <br /> FIN�L INSPFCTION ale /�� �� �5� S� <br /> ApprnveA 25 ConslruCled ignnture ol Apphcant le <br /> � ' PUBLIryyORKSDEPARTMEN7 WORK AUTHORIZED BV THIS PEfiM1T MUST BE STAR7ED WITHIN <br /> � 3200CedarS�ree1 180 DAVS OF DATE PERMIT IS ISbUED AND THEREAFTER IS TQ <br /> Everel�.WA 9B701 BE DILIGENTLY PURSUED TO COMPLETION THIS PERMIT MAY BE <br /> Phone�259�8910 CANCELLE� BV THE CITV UPON ANV STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS UUR�TIOM <br />