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Date 4 <br /> —'�0-93 (lot; / <br /> FuckWpras a perm • _{../(_)_ <br /> Application For eidp Depl.e <br /> PUBLIC WORKS PE �� uUi_Wee FeeR T mFeejo <br /> a <br /> L-66 eppt Fee Pmd <br /> Print or Type Only Balance Dee _ /�✓— <br /> Select homes 237 Elm St Everett WA 98203 258-1503 <br /> Owner Mailing Address City Zip Phone <br /> Owner <br /> Applicant Mailing Address City Zip Phone <br /> Describe Proposed Work new house _ Z <br /> I <br /> Project Address(if known) _5 '�1 p�_j�✓ CL O <br /> Lot 38 Dive 3 <br /> Attach four(4)copies of plans for proposed work• Draw to scale and note thL following as applicable: <br /> • Property Lines �a <br /> • Centerline of street I_ <br /> • Outline and dimensions of all existing and • Indicate North rY^♦ <br /> proposed structures on the lot • Show any proposed grading changes <br /> • Existing Bad proposed utilities • Show measurements <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS O <br /> 1.All calls for Inspection shall be made 24 his.in advance•phone 259.8810. <br /> 2.All work shall be performed In accordance with this permit and current City of Everett Design and Construction <br /> Standards and Specifications. <br /> 3.Cell Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1.800.424.5555. <br /> 4. Install track 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 /> 6. Curb 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- VI/ <br /> spector, width at prop line limited to existing apron width. O <br /> 8. Connect all roof, yard and driveway drains to storm drain <br /> system provided to lot. <br /> 9. Adjust water boxes to grade at end of construction. <br /> J� 10. Driveways shall be completely cured before driving on them. <br /> N <br /> (1 ACKNOWLEDGEMENT OF CONDITIONS <br /> The unders7gned owner/applicant hereby agrees 10 hold and save harm. <br /> less the Lity of Everelt from any and all claims for damages, costa <br /> expenses, or causes of action that may arise because of installation <br /> and maintenance of the improvement or other right•ol•way use hereto <br /> applied for and further agrees to remove same upon notice from the <br /> Approved for Cons ueti n Dale <br /> Clt a Id ore latqje,Iublic property damaged thereby. <br /> Gam' is i3 f� Ii; <br /> FINAL INSPECTIONDate <br /> Approved as Constructed <br /> Slgnatur of Applicant III 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 /> i 1 <br />