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DB,Q� / �� runi�cworxape6.m� il• �✓— �%i <br /> Applicetlon For eiaa oen� . / �L�3s __ <br /> PUBLIC WORKS PERMIT PueTotpieaFee � -- _ _ <br /> Lev 11no� iee Pai� S <br /> Print or Type Only e.�.��,o�s S���`� _ <br /> �Y�/'G <br /> T NC�QuM �- Sli�SGG�S��vU{-�un .�3�a 13G"�P►.S c., �.vnnu.ladd.�•fu. 7�,5'- `1?b� <br /> Owner Mailing AAdress City i� Phone <br /> s R M.e � aI4J� <br /> AppGcan� �eniling Add�ess Cily Zip P!ione <br /> Deacrlbe P�oposed Work � 11���� �.r1�a l�(�-�`K�"� ' <br /> � <br /> �✓/- �c�9y"S�:S,E W <br /> Prolect Address�il knewnl �_�'� 1.�. + (�� o�+� S `�-. F-�q'�-U-� . � <br /> Attech lour(41 copiez ol plans lor proposed work� Drxw to scale and nole Ihe tollowing es•ppGcable: � <br /> • Properly Lines A Centc�line ol streel � <br /> • Outhne and dimensions of all ezisling anJ • Indicete Norih <br /> proposed sVuctures on Ihe lot • Show eny proposed grad�ng chnnyes <br /> • Ezisting enJ proposed utililies • Show measuremenls � <br /> DO NOT WRITE 6ELOW THIS LINE O <br /> P[RMIT COI�DITIONS <br /> 1. All calls lor inspeclio�shall he�nade 24 hrs. in aAvnnce� phone 25J•8B'I S � <br /> 2. All work shAll be performed in eccordTnCe wilh Ih�s permlt anA cdirCnt Cily o� Everetl Desiyn and Cons�ruclion <br /> Stande�ds end Specillcetlons. <br /> 3. Call Location Untlerground Servlce 48 hrs. belore you dig.TOLL FREE NUMBER �•800•424•5555. � I <br /> 4. Thie lot dependa on a lift station for eanitary sewer =ervice. 1he City has <br /> not accepted the lift station for operation and maintenance as of this date. � <br /> Occupancy of reaidence will not be allowed until the City accepts the lift <br /> atation. <br /> 5. Down spout from the house are to ba tight-lined to the curb drain. H <br /> 6. My grading oF thia lot is to be done so as not to impact the adjoining lote ♦/� <br /> with rain aater run-off. N♦ <br /> 7. Sidewalk is new and unbroken. Any damage to it will require replacement by O <br /> the ap��licant. � <br /> ACKNOWLE�G[MENT Uf CONUITIONS <br /> The undris�gneJ owne�/Applicent nereby egreea to hold And save harm� <br /> les, Ihe Cily ul Everett from eny and a'I claims �or Anmagea costs, <br /> �� � � expenses, or CFluses ol ection �hat mny ari9e because o� in5tellation <br />� ��� /���� A maintenance ol Ihe imprOvement u� o�her righbol-way use hereto <br /> epPlled lor end lurther agrees to remove eame upon nollce Irom Ihe <br /> roved 1 r Co n uclig � e�e Cily and to replace public property dameged thereby. <br /> o � 5'7 -(� I `1 ' ,, <br /> FINAI IN PECTION Date ��_�1 <br /> ApproveA as Constructed Sii�nalure ol Applicant �, � ale <br /> everr�l PUBLIC WORHS DEPAqT�dENT WORK AUTHOHIZED BV THIS PEFMiT IviUSI BE STARTED WITHIN <br /> � :1200CedarS�ree1 I lA0 DAVS OF DArE PERMIT IS I„SUED AND THEREAFTEI� IS TO <br /> Evuett.WA 98201 BE DILIG[NTLV PURS�IED f0 COMPLETION. THIS PERMIT A�AV BE <br /> Phone. 259�8�15 CANCELLED 1:Y THE GITV UPON ANY S'.OPPAGE OF WOP.!:ON 'HIS <br /> PROJE�T OV[R 90 DAYS DURATION. <br />