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r-. <br />; <br />, <br /> � �' <br /> �,-, <br /> syti � <br /> -, x <br /> HZ � � /� � � / <br />� �N 'RI Date�Y� � �l a�ni,�w���sF�,���i. �1L53 <br /> � � TO POSTING � ,�qo��, ,�_��_ <br />� y AFP�ication For <br /> o�� PUBL.IC WORKS PERMIT °°°��°°�°«=F�° <br /> �o���Fe� s <br /> �ess nno�.Fo�a.,m 5_��_q <br /> �tf 3aiancc�ur $J�_ <br /> y��� Print or Type Only <br /> i � H �`-� �1-nnrrr) �c//� A/ ���h ,sf- .SPalf�e /c� /D,� ��J)-�a/.j <br /> g� Owner Mailing Address Gly Lp Phone <br /> H <br /> I O C Cn <br />, �� � , ,. - <br />( 'y�H (p ApV���ant Mailing Address City Zip P{ione <br /> 4 H o [n 02/27/91 10:07RM OOOAH5835 C:F;:� <br />� Describe Proposed Work _lc���� S �' � ' cSt.B�" <br /> FIOf, $5.?2.50 <br /> FLEG 5'i5.OG <br /> �U6 — 24�4 �IZ � � W <br /> Prolecl Address lif known) �dT 9- �a,rv12iE- .7IL 4�G.0� � <br /> �9— <br /> Attach four(4)copies ol Flans lor pmposeJ work� Draw to scale and note the following as applicable� WpTER $60.�0 �� <br /> • Property Lines • Centerline of s�reet Wp00�H128 r^ <br /> • Owline and dimemsions of all existing ann • Indicate North "sEW R 4�30.00 r� <br /> proposed structures on�hc lo� • Show any proposed gradi g a❑q es <br /> • Ezisting and proUosed ulilities • Show measurements �1� -0 4650.00 � <br /> CHECt; 4143^.�0 <br /> '�1 DO NOT V��RITE BELOW"iHIS LWE O <br /> PERMIT CONDITIONS <br /> y' 1.PII calis for insper;;on shall be made 24 hrs.in ad��sr.:.z�phone 259•8810. � <br /> 2.l,II work shrJl Cd pedormed in accordance with ihis permi:and current City of E��:-reti Desinn and Constmction <br /> '�� Standards end Specificalions. <br /> 3.Call Locadi��n Underground Szrvice 48 hrs.betore you dig.TOLL FREE NUMBER 1•800•424•5555. � <br /> ��' 4_ Inatall rock construction entrance behind driveway as <br /> per city etandard #208 to eliminate tracking ^_�e�d onto ^ <br /> �' atreets as directed by Publ.ic Worka Inepector. �J <br /> � 5. Reep city atreeta cle�m at all timea. <br /> �e 6_ Curh:, gutter and sidev�alk in the plat ar3 new ..:.d � <br /> undainaged, any damage i:hereto ahall be replaced at the <br /> '"1 diar.retian of the Public i►orka Inapector. � <br /> 7_ My change in the drivenay cut muat be app^oved by the o <br /> ��� Public Wurke Inspector. <br /> 8_ 7'i.ghtline al.l roof, 7�ard and drivevray draina from <br /> ' �� h�usea to C.S_ stu6s aL' back of aide walk with rubher a <br /> � gaskat P_V.C_ pipe <br /> 9_ Adjust water boxea to grade at end of constri�ction_ <br /> 10_ UrivNways ahal7. be r.ompletely cure� :,efore driving on <br /> O -I �f�l / 1:h('.Ot_ ACKNOWLEDGEMENTOFCONDITIONS <br /> / � <br /> � �C>,�«J� The cndersiqned owner/applicant hereby agrees to hold ar d s:ve harm- <br /> � -- less Ihe Cdy o( Everetl from any and all claims for Aamac�es, cos�s, <br /> -- -� - � expenses, or causes of action that may arise Uecause o� �nstallation <br /> _ ^ ,,,���_ z_��_c�I antl maintenancr. of ihe imp��vement oi o�her ri�h4o��way use here�o <br /> Gl,la.X-Y��_ applied �or anr! furlhci a9rees to remove :�-. + upon notice Irom the <br /> Approved for Consiruction �<<e C�ly and �� ±�7ac.: public properry dama9eJ !i.- reby. <br /> ;' i <br /> ��/ �/��` �����, �/ / - ,G— . <br /> �`-�,-c' _i�`�`-�-a—��,-'" <�; <br /> PRAL INSPECTION � � Date' -� - <br /> Appr�yed as Constru:�ed � 9n�!�re�f Applican Date <br /> leverell PUBUCWORKSDEPARTMENT �NCRK AUTHORRED �Y THIS PEHMIT MUST BE STARTED WITHIN <br /> I� 3200CedarSlreet 180 DA'f5 OF DA1E PERMIT IS ISSUED AND THEREAFTER IS TO <br /> / BE DILIGENTLY PURSUEO TO COMPLETION. TIiIS f ERMIT MAY BE <br /> Everett,WA�8201 CANCELLED BY THE CIT"UPON ANY STO�Fl,GE�`.�_\VORK ON TNIS <br /> Pho�e:259�Fi810 PROJECT O:ER 90 DAYS DURATION. <br />