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.a <br /> b Date-3--ii--.'12 PubLc Wens Permit <br /> A Application For 9,4,peer a 35845 <br /> PUBLIC WORKS PERMIT PublmWPrksree ` -- <br /> rM Fee <br /> �y7 n (�[' 1 (`G z / Less Am.Fee Pus 9 <br /> bC] '.r 'o Print or Type Only �� CIMTI N7- � aebm:e pus d Z42 <br /> [O � <br /> o nHr� Countrywood Homes 14410 Bel-Red Rd. 8200 Belleuve WA 98007 644-2323 x142 <br /> Pit M <br /> -i Owner Mailing Address City Zip Phone <br /> rm- Angie Stevens <br /> M <br /> H Owner <br /> Applicant Mailing Address City Zip Phone <br /> N H - '\ <br /> W to <br /> Describe Proposed Work SFR Lot 6 FAV L)ETx=M I L-L <br /> w _J' <br /> Project Address III known) Z5119 - 591 ST SSV �- ---- -- ---- - W <br /> Attach four(4)copies of plans for proposed work-Draw to scale and note the following as applicable <br /> • Property Linea • Centerbne of street /A <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 <br /> Im <br /> 00 NOT WRITE BELOW THIS LINE O <br /> i 1 PERMIT CONDITIONS <br /> 1.All calls for inspection shall be made 24 hrs.in advance-phone 259.8810. sal <br /> 2.All work shall be performed In accordance with this permit and current City of. verett Design and Construction <br /> Standards and Specifications. <br /> 1 3.Cell Location Underground Servire 49 him before you dig.TOLL FREE NUMBER 1.800.424.5555. z <br /> 4. Install rock construction entrance behind drivewjy ar, rcr rit.v <br /> standard #268 and erosion control as directed by Public Work:; O <br /> Inspector. <br /> 5. Keep city streets clean at all times <br /> 6. Curb gutter and sidewalk in the plat are new and undamaFrerl. <br /> any damage thereto shall he replaced at the discretion of thr <br /> Public. Works Inspector. <br /> 7. Any change in the driveway cut must, be approved by the PW In- O <br /> spertor. wi.dth at. prop line limited to existing apron width. <br /> A. Connect All roof, yard Find driveway drains to storm drain 0 <br /> system provided to lot. <br /> 9. Ad,iust 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 hereby agrees to hold and save harm. <br /> «� ------ less the City of Everett from any and all claims for damages, costs. <br /> `1 expenses, or causes of action that may arise because of installation <br /> 1-1 C 3 <br /> and maintenance of the improvement or other right-ol-way use hereto <br /> Approved for Construction Date applied for and further agrees to remove same upon notice from the <br /> City and to replace public property damaged thereby.. <br /> FINAL INSPECTION Dale <br /> Approved as Constructed Ig ra ure o pplicanl Dale <br /> 1056 7 PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> M 3200 Cedar Street 190 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett,WA 88201 BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Phone;lbs-9810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />