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Da'e__ <br /> 9/11/91 <br /> T(1 PVINf uDbeWorksParme. 9� <br /> Application For r ams Door . 0117760 <br /> PUBLIC WORKS PERP41T PODIk Wurb Fe. -- <br /> f Tot.I Fir >< <br /> r7 Les. PPI Fite Psid 9 <br /> J <br /> Print or Type Only g g g g 8 Zb <br /> a. <br /> Hanabrook Inc E 4020 Maia Spokane We 99202 06 M <br /> Owner Mailing AddressZIP s. Phone <br /> T <br /> Applicant Mailing Address City ZIP Phone <br /> Describc Pr-- sed Work Construct new 1219SF house <br /> Project Address(if known) _202 59th Pi SE UJ <br /> Attach lour(4)copies of plans for proposed work- Drew to scale and note the following as applicable: <br /> • Property Lines <br /> • Outline and dimensions of all existing and • Centerline of street <br /> • Indicate North <br /> proposed structures on the lot • Show any proposed grading changes <br /> • Existing and proposed utilities • Show measurements <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS <br /> 1.All calls for inspection shall be made 24 hrs.In advance-phone 259.8810. 0 <br /> 2.All work shall be performed in accordance with this permit and current City of Everett Design and Construction <br /> i Standards and Speclllcations. <br /> A Call Location Underground Service 48 hra.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 O <br /> Inspector. <br /> 5. Keep city streets clean at all times <br /> E. Curb gutter and sidewalk in the plat are new and undamaged, <br /> any damage thereto shall be replaced at the discretion of the I— <br /> Public Works Inspector. ♦/� <br /> 7. Any change in the driveway cut must be approved by the Public V♦ <br /> Works Inspector. O <br /> 8. Tightline all roof, yard and driveway drains to Storm drain ^ <br /> stubs at back side of sidewalk. li <br /> 9. Adjust water boxes to grade at end of construction. <br /> 10- Driveways shall be completely cured before driving on them. <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> 1 ) The undersigned owner/applicant hereby agrees to hold and save harm. <br /> r less the City of Everetl from any and all claims for damages. costs. <br /> pal tA—Qexpenses, or causes of action that may arise because of Installation <br /> �'v' �..�.—Cl.' and maintenance of the improvement or other right-of-way use hereto <br /> Approved for Construccctttfff000n Date applied for and further agrees to remove same upon notice from the <br /> City and place public property damaged thereby. <br /> I;z_ _ <br /> FINAL INSPECTION Date _ i( <br /> Approved as Constructed Signature of 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 /> 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 />