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DatoIL* f <br /> O5T I N G Pueue Worts•Form,• Q5/278 <br /> Application For ' <br /> 8Wp DeDI, <br /> PUBLICWORKS PERMIT Nblicrks FeeTotal Fe,, <br /> , <br /> L•••APPI.Fee Paid S�� <br /> Print or Type Only Balance DU <br /> $ Z�— <br /> h'yner Hornes Incorf)oroted 20909 Uuhuqu,,_itoad Snohomish , Wa Y8290 <br /> r , <br /> Owner Mailing Address . City -, L <br /> p Phone <br /> Applicant Mailing Address <br /> house C'ty Zip Phone <br /> Describe Proposed Work <br /> Lot 3 City of Everett Short Plat #1202-14-95 <br /> Project Address(it known) S- Will reg W <br /> Attach four(4)copies of plans for proposed work•Draw to scale and note the following as applicable: ■ <br /> WM <br /> • Property Lines •Centerline of street <br /> • Outline and dimensions of all existing and • Indicate North <br /> Proposed structures on the lot • Show any propoaad grading changes <br /> • Existing and proposed utilities • Show measurements M <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS O <br /> 1.All calls for inspection shall be made 24 hire.in advance•phone 259.8810. <br /> 2.All work shall be performed in accordance with this permit and current City of Everett Design ani Construction <br /> Standards and Specifications. <br /> 3.Cell Location Underground Service 48 he&before you dig.TOLL FREE NUMBER 1.800.424.5555. <br /> 4. Keep City streets cleall at all hales. z <br /> 5. Tighdnte Ioof nlil ofrtu cleek Via a SW facie draiu lane. <br /> 6. Trees identified by the approved"Tree Preservation Plan" on life wilh file Planning Department shall not be <br /> cut, except for dead, dying or haz-ardous trees, as approved by the Planning DepailmenL H <br /> 7.Trees that are to be saved must be fenced at the drip Wu prior to airy clearing, grading, and/or construction. <br /> B. An erosion control fence is required along the buffer. //� <br /> 9. No grading, filling, alteration, or placement of tinctures wIL be allowed in the en.vorunentally sensidvc arca V o <br /> except as MITI in the terms of approval for Otis short sgbdhirion. All structures must be set back front tit O <br /> edve of the butler a minimum of 5 teat. <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees tc hold and save harm- <br /> less the City of Everett from any and all claims for damages, costs. <br /> /�— expenses, or causes of action 'hat may arise because of installation <br /> Z(J <br /> and maintenance of the improvement or other right-of-way use hereto <br /> Approved for Cons ction ale applied for and further agrees to remove Same upon notice from the <br /> City a to replace public property damaged thereby. <br /> FINA�PECTION Dale „� (o.Z , <br /> Approved as Constructed Slgnelur9.5 <br /> e P1 Applicant <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 /> CL Everett,WA98201 BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Phone:259.881V) CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />