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MR <br /> — <br /> Date-9111/91 Tin D(►CT111f °u°'.w01MiPnin91I2 6 2 <br /> DOM a -- <br /> Application Fo•. -Mft <br /> 5 PUBLIC WORKS PERMIT 'Kw° eF. <br /> iMei lee <br /> L"Ie ADM res Pe,e S _ <br /> AN aebn°e Due S �� <br /> °a H rn Print or Type Only �- S <br /> H Ho ern;. <br /> H Hanabrook Inc E 41120 Main Spokan� 53 40644 " <br /> N�rt Owner Mallin AUdPq f ru� yL!! F LCy�dy� �� zip <br /> Phone <br /> z3 o uiru�i :+ aSii i� c' i3 <br /> H d Applicant Mailing Address City Zip Phone <br /> O " <br /> " M8 <br /> Q. O Describe Proposed Workz H <br /> ena rr rr 1 t a6SP�' i t 1 <br /> y Ez1 <br /> to W <br /> �+ q <br /> nbN 1 <br /> q c �— <br /> Fm <br /> 3 Crl 225-59th Pl $E <br /> Protect Address(11 known) - <br /> Z -3 N Attach lour(4)copies of plans for proposed work. Draw to scale and note the following as applicable: <br /> �-3 O rn • Centerline of street <br /> • Properly Lines V/ <br /> • Outline and dimensions of all^xishng and • Indicate North <br /> proposed structures on the lot • Show any proposed grading changes <br /> • Existing and proposed utilities • Show measurements pyo <br /> DO NOT WRITE BELOW THIS LINE Wja� <br /> PERMIT CONDITIONS (`J� <br /> 1.All calls for inspection shall be made 24 his.in advance-phone 259-8810 <br /> 2.All work shall be performed in accorrance with this permit and current City at Everett Design and Construction <br /> Standards and Specifications. <br /> 3.Cali Location Underground Service 48 his before you dig TOLL FREE NUMB6A t 1100.424.5555. Z <br /> 4. Install rock con>tructinn entrance behind driveway as per city O <br /> standard 02.011 and srosion control as directed by Public Works <br /> Inspector. <br /> 5. Keep city streets clean at all times <br /> 8. Curb gutter and sidewalk in the plat are new and undamaged, <br /> Anv 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 Public <br /> Works Inspertor. <br /> 8. Ttghtline all roof, yard and driveway drains to storm drain ^ <br /> atubs at bee' side of sidewalk. L6r <br /> 5. Ad,iust water boxes to grade at end of construction. <br /> lo. 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 /> (1 1/1/1 L I A .7�I SCJ 1 and maintenance of the improvement or other right-of-way use hereto <br /> 1.I l ,Jy`T' / applied for and further agrees to remove same upon notice tram the <br /> Approved for Con lion Dale City and to replace public property damaged thereby. <br /> FINAL <br /> Date ` <br /> Approved <br /> INSPECTION Date <br /> Approved as Constructed WORK A of Applicant <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> PUBLIC WORKS DEPARTMENT 180 DAYE OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200 Cedar Street 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:259.8810 PROJECT OVER 9C DAYS DURATION. <br /> a <br /> 1 <br />