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r <br /> all <br /> r� a� <br /> Public Wmu Permd e v T <br /> Date 9/11/91 TO POSTING ' Z ' g ``/ <br /> Brae peir • 91177.481 <br /> Application for <br /> PUBLIC WORKS PERMIT PPbimtlieefee • <br /> H Leu xPPI Fee PAM $ <br /> 1-1 "3 f 2 � � .'.. 1'J aelerKa Due • <br /> a H to Print or Type Only <br /> H 3 01 L� P .n C) C r:1m <br /> r! <br /> N <br /> H pJ <br /> Ilanabrook Inc E n <br /> 4010 Plain SOokano k',1 99n0n ;7t.-DG <br /> H Owner Melling ddress, Gnyi <br /> , : (ry r •4Zip Phone <br /> , cr- <br /> V7H P ao : Y � , v' �..T MR 3 <br /> um � q ei- ilii <br /> 1,t K <br /> tOl <br /> O t7 Applicant Mailing Address City '.P Phom <br /> = mg <br /> n. 0 Construct new 1196SF tri-level <br /> H Describe Proposed Work <br /> z — <br /> r z <br /> H H <br /> W W <br /> gGti <br /> j Project Address(if known) 211 59th Fl SE <br /> z H C4o� <br /> H O to Attach four 14)copies of plans for proposed work-Draw to scale,.nd note the lollowing as applicabl, <br /> • Property Lines • Centerline of street <br /> • Outline and dimensions of all existing and • Indicate North v <br /> proposed structures on the lot • Show any proposed grading changes <br /> • Existing and proposed utilities • Show measurements /yam <br /> DO NOT WRITE BELOW THIS LINE Wjs♦ <br /> C J PERMIT CONDITIONS 259.8810. (a n <br /> C �� 1.All calls for ll b inspection shall in made 24 hrs.m chis nceper - t and <br /> 2.All work shall be performed in accordance with this permit,mil current Gly of Everett Devon and Con,tn¢onn <br /> Standards and Specification& <br /> •... 3.Cell Location UndergrounJ Service 48 hrs before you illi) TOLL FREE NUMBER 1.800424.5555. z <br /> 1P, Install r-o :' construction entrance behind driveway as Der cit' <br /> standard N.''iU and erosion control is directed by Public Works <br /> Inspr_ctor. <br /> Keep r_.tty streets clean at all limns <br /> b. Curb nuts -r and sidewa11, 1.n th:• olat art new and ttndamaaed, <br /> anydamage thereto shall be rr r�• viced . t. .he discretion o1' the <br /> Pi-iblic Works IIISPectfll-. <br /> 7. Any change III the drlvf+want clit must be apPrnved by chi_ F'ubi i � <br /> Works Inspector. <br /> 8. Tiqhtline all root , ;,aril and driveway drains to storm dram <br /> etuhs at bac) side of sldLwall . <br /> s 9. Ad iust water boxi?5 to (Ir n•.jp at end of ronstruct ion. <br /> ` - <br /> Co. Driveways shall be co-apletely r_ur-ne' 'Y�fcre drlvinc on them. <br /> ACKNOWLEDGEMENT OF CONDILONS <br /> w The undersigned ownertapplicanl hereby sgrees to hold and save harm- <br /> less the City of Everett from any and all claims 'or damages, coals, <br /> axpenses. or causes of action that may arise because of Installation <br /> C �_ Ai —11 and maintenance of the improvement or othar right-of-way,use hereto <br /> 1 U Q hp / applied for and further agrees Io remove same upon notice from the <br /> Appr ved for CC strucbon Date City a or to replace public properly damaged Iherebi <br /> FINAL INSPECTION Dale Date <br /> Approved as Constructed Signature of Applicant <br /> PUBLIC WORKS DFPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> CW 3200 Cedar Stree'. BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Everett WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259.8?10 PROJECT OVER 90 DAYS DURATION. <br />