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Date—4L2$Lw 7 <br /> TO rimimG I ' � Lip�u,.blftr <br /> PomnBids . I� i <br /> r4,phr:Tion f nr <br /> PUBLIC 4040 <br /> WORKS PERMIT <br /> res <br /> Print or Type Onl PupY S <br /> Countrywood }{rimes 1441el <br /> Owner M <br /> 0 Bel-Red Rd Suite 200 Bellevue WA 98007 \ <br /> elknp Address <br /> City Lip Phone <br /> Owner <br /> Applicant Mailing Address <br /> City Zip Phone �� <br /> Describe Proposed Work _ nem hoho rip --�_ <br /> Project Address(if known) 2 29 SRth Sr Std _ LU <br /> Attach four(4)copies of plans for proposed work• Draw to scalIs <br /> a <br /> • Property Lines and note the following as applicable: <br /> • Outline and dimensions of all existing and • Centerline of street err <br /> • Indicate North <br /> Proposed structures on the lot tf N <br /> • Existing and proposed utilities • Snow any proposed grading changes v♦ <br /> • Show measurements <br /> DO NOT WRITE BELOW THIS LINE Co <br /> PERMIT CONDITIONS <br /> ' 1.All calls for Inspection shall be made 24 lire.in advance-phone 259.8810. o <br /> 2.All work shall be performed in accorddnce with this permit and current City of Everett Design and Construction <br /> Standards and SPBCilications. <br /> 3,Call LOcntion Underground Service 48 lira before you dig.TOLL FREE NUMBEn 1.600.424.5555. <br /> 4. Install rock construction entrance behind driveway as per city Z <br /> standard #208 and erosion control as directed by Public Works <br /> Intepertor. <br /> 5. Keep city streets clean at all times <br /> 6. Garb gutter and sidewalk in the plat are 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- <br /> spector, width at prop line limited to existing apron width. o <br /> 8. Connect all roof, yard and driveway drain to storm drain <br /> system provided to lot. CL9. 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 herebyagrees to hold and save harm <br /> lase the Clly of Everett from any anO all claims for damages costs, <br /> expanss <br /> s/'7�3 and maintenance of the mprrovemCauses of action aentlor then ay arise right-of-way use hereto <br /> ecause of Installation <br /> Approved 1�41ru;llon Dale applied for and further agrees to remove same upon notice from the <br /> and to replace public property damaged thereby. <br /> FINAL INSPECTION <br /> Approved as Constructed Dale <br /> ure 01 Aoplicanl 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:259.8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br /> _ 1 <br />