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;. <br /> Y Puulro wpl4r Permll e <br /> la Z If <br /> Date— 2 1 9 Bldg Dept a D 1 V <br /> Application Fob <br /> WORK PERM r"I"TIWG__ n Pupl¢W,rex Fee S_ <br /> PUBLIC olal ree <br /> R Uu Appl fee Pd,d S <br /> 8114,0 N. 516L— <br /> Print orType Only P � Sy8y�� Fg . <br /> p O N Rsell <br /> Countrywood Homes 14410;1BeWLd=,R* ~Bellevue "'A007 e;44-2323 <br /> Phone <br /> Owner Maihnp A\rMs't p <br /> YJ <br /> Same i, <br /> Applicant <br /> lddress <br /> ulty Zip Phone <br /> G <br /> New house - Basic 247 _ <br /> Describe Proposed Work <br /> Elzow <br /> Protect Address Ill known) 261) 57th St SW___ Lot 39 Powder Mill Div 2 <br /> Attach lour(4) copies of plans for proposed work•Draw to scale and note 0 Ce^I1ew'ne of strreeas lt able: <br /> • Property Linea • Indicate North <br /> a Outline and of of all existing end 0 Show any proposed grading changes <br /> proposed structures on the lot 0 Show measurements <br /> • Existing and proposed utilities <br /> DO NOT WRITE BELOW",SIS LINE O <br /> PERMIT CONDITIONS <br /> 1.All calls for Inspection shell be made 24 hrs.In advance•phone 259.8810• <br /> 2.All work shall be performed In accordance with this permit and current City of Everett Design and Construction <br /> Standards and Specifications. <br /> 3.Call Location Underground Service 48 his.before you dig.TOLL FREE NUMBER 1-000-424-5555. <br /> 4. Instal rock construction entrance behind driveway as per city <br /> standard#208 and erasion control as directed by Pubic 1Vorks <br /> Inspector. <br /> ti. Keep city streets clean at all times <br /> 8. Curb gutter and sidewalk in the plat are new and undamaged, <br /> any damage thereto shall be replaced at the discretion of the <br /> Pubic Works Inspector. �♦ <br /> 7.Any change in the driveway oul must be approved by the PW In- <br /> spector,width at prop line limited to existing apron width. 0 <br /> 8. Connect al roof,yard and driveway drains to storm drain <br /> system provided to lot. sell <br /> 9.Adjust ys saterbal be comcxes to pade 3t end letely f pletely curredbefore driving on them. <br /> 100 Driveways <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> ---- <br /> The undersigned owner/applicant hereby agrees to hold and save harm- <br /> les4 the City of Everett from any and all claims to, damages, costs. <br /> oxpenses, or causes of action that may arise bec,luse of installation <br /> �7 qand maintenance of the improvement or other rig:lt-ofway use hereto <br /> � _ applied for end further agrees to remove same upon notice from the <br /> Data city and to replace public property damaged thereby. <br /> Approved for Construction <br /> Ito. q L <br /> Date Date <br /> FINAL INSPECTION Ignature of Applicant <br /> Approved as Constructed WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> PUBLIC WORKS DEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200 Cedar Street BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY IS <br /> 007r Everett,WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259-8610 <br /> PROJECT OVER 90 DAYS DURATION. <br />