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i <br /> I <br /> I <br /> i <br /> oate.�"��['"_`�`5 �.,�, ,,.,,,�. ly� -j�C�t-3�-1q1 � <br /> �. I <br /> Applical,un For ur.° n�.��i . — U.�"_._ __ _ U—_ . <br /> �UBLIC WORKS PERMIT °°,°� W°„°,�° - - <br /> r„�,�,�� : <br /> t.r.•.e nP01 Fev P..�f S � <br /> Print or Type Only e,,�a��.�o��e s_�12_� <br /> Geonerco Inc. 1q14 N. 34th M10� Seattle, WA 98103 547-8213 <br /> Owner Maihng Address Clly Zip Phone <br /> Same <br /> Applicenl Aaailmg AAdrt�ss Gty Zip Phone <br /> Describe Proposetl Work _Naw single family residence I.ot 1` 'iWin Cedars _ � <br /> Pro�ect Address lil knownl . -'�U 5 ��� ��. iy — � <br /> � <br /> Allach Inur(41 cople5 0l plan9 lor p�oposed wmk- Draw l0 5cn!e T�d nofe Ihe lollowing 05 apUhcahle: � <br /> • Property Llnes • Cenlerline ol slrcel � <br /> • Outline and dimensions ol all existing and • InAlcote North <br /> proposed 3irucluros on�he lo� • Show any propos�d yradin9 changes <br /> • Ezistiny enc' pioposeA ulihhes • Show maesuremenis � <br /> ���� <br /> DO NO(WRITE BELON�' THIS LINF: O <br /> PERMIT GONDITIONS <br /> t All r,alls lor inspeclion s' �II be made 24 hrs. in adv�u�e � phone 259•88:t� � <br /> : All work shell bo perlorn . 'in accordance with ihis permit and current City ol -vorell Ucsa�n and Conshuction <br /> Slandxrds end Soecifications. <br /> 3 Coll Location Unc'ei7round Service 48 hrs. Uolore you dig.TOLL FREE NUMBER 1•800•424•5555. � <br /> 4. O�rb, gutter, and sil�walk are n�w 6 unbroken, any dama5e to them shall O <br /> be repaired/replaced by the applicant. <br /> 5. Any driveway location changes must be approved by the Public Works �ept. � <br /> and inspPcted rrior to construction. <br /> 6. Use public dra Lnage system provided for roof-top downspouts. v♦ <br /> O <br /> a <br /> ACHNOWLEUGEMEN7 OF CONDITIONS <br /> The undersigned cwnar/applicnnl he�e6y ng�er,s�o hold nnA seve harm- <br /> - less the City ol Everelt Irom eny and all clsims for dameges, costs, <br /> / n ezpenses, or couses ol action Ihat me� �,:ise bec:,u=_e ol in��a!lauon <br /> L�/' ����. / L , �� end meintonence ol the impwvement o� othei riyht�ohway use L.,�rw <br /> /V <br /> npplied lur end lurther egreos lo remove seme upon nolice irom ihe <br />� App�oved br Const ction ate pi ��� �a reploce public p�operty dameged Ihereby. <br /> /�' � , 'r <br /> j / l <br /> i <br /> �` 'E-� `D - ,f I,1 I �' <br /> FINAL INfiPECTI��/���/�s` l O++te __ ! _�'� �1� [���� �Y`�� � 0�/ <br /> Approved 35 Conslrucled E�ignnture ol Applicanl � Dete <br /> I evrm�� •^l18LIC WORK^ DEPARTMENT WORK AUTHORI2ED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 180 DAVS OF DATL PEflM1T 19 ISSUED AND THEAEAPTEP IS 'i0 <br /> 3:00 Ceda� S �el pE DILICiENiLV PI�qSUEO TO COMPLETION. THIS PERMIT MAV C9L <br /> EVCfetL WP 9Ai01 <br /> i� CANCELL�D BV THE CITV UPON ANV STOPPAGE OF WORK ON TI115 <br /> Phone: 259�NG 15 FROJECT OYER 90 DAYS DURATION. <br /> � <br />