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I <br /> Date 10-1-93 <br /> Pvb1¢Wort.Permd• / �� <br /> Application For TP PMI NG 3_-?y -9" Bldg Peer o. <br /> PUBLIC WORKS PERMIT �bTglalFee Fee 6 <br /> Le..APPI Fee Peed S <br /> Print or Type Only Beluae Due S �' <br /> Se:ect Homes 237 Elm St Everett WA 98203 258-1503 <br /> Owner Malling Address City Zip <br /> Phone <br /> Owner <br /> Applicant Mailing Address <br /> CnY Zip Phone <br /> Describe Proposed Work new house Lot 45 Hanabrook Div 4 ,G <br /> 1. <br /> Project Address(if known) 118 58th P1SW✓ Uj <br /> Attach four(4)copies of plans for proposed work• Draw to scale and note the following as applicable: N <br /> • Property Linea • Centerline OI street <br /> • Outline and dimenalona of all existing and • Indicate North <br /> �. proposed structures on the lot • Show any proposed grading changes <br /> • Existing and proposed utilities • Show measurements M <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS <br /> 1O <br /> 1I.All calla for inspection shall be mode 24 hrs.in advance•phone 2t9.41810. <br /> 2.All work shall be performed In acarrdanco with this permit and curren' ;ily of Everett Design and Construction <br /> Standards and Specifications. <br /> 3.Call Location Underground Serv;„a 48 hrs.before you dig.TOLL FREE NUMBER 1-800.424.5555. <br /> 4. Install rock construction entrance behind driveway as per city Z <br /> Standard #208 and erosion control as directed by Public Works <br /> Inspector. O <br /> 5. Keep city etreeta clean at all times <br /> S. Curb gutter and sidewalk in the plat ars new and undamaged, <br /> any damage thereto shall be replaced at the discretion of the �.+� <br /> Public Works Inspector. <br /> 7. Any change in the driveway cut must be approved by the PW In- Cn <br /> Spector. width at prop line limited tc• existing apron width. <br /> 8. Connect all roof, yard' and driveway drains to Storm drain <br /> system provided to lot. li <br /> 9. Adiust water boxes to grade at end of construction. <br /> 10. Driveways shall be completely cured before driving on them. <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm• <br /> less the City of Everett from any and all claims for damages, costs, <br /> expenses, or causes of action that may arise because of Installation <br /> /7 and maintenance of the improvement or other right-of-way use hereto <br /> Approved to Conslr ctioc /Dale y appked for and funher agrees to remove same upon notice from the <br /> �- i7 City alip to replacepublic prope ty damaged thereby. <br /> FINAL INSPECT'ON Date <br /> Approved as Corslructed Signature of plicant <br /> Date <br /> PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200 Cedar Street 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett.WA 98201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone:259.9810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br /> s <br />