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51 <br /> F <br /> i <br /> Date_8/lW92 weak Worxr rrrmn• _[��•/ <br /> ewv Dore is 37741 <br /> Application For <br /> H PUBLIC WORKS PERMIT Percolor reer`r s <br /> y H Len APPI rte Paid 5 <br /> c! HH <br /> Q Le�rre Dee 6 <br /> H�aPrint or Me RVOT 1r <br /> H53 <br /> K n <br /> H�1 <br /> O x 0 Count 7d Homes 14410 RPI—Red Ad 11900 z tteo„e ma OAn37 644-2323 <br /> NH Owner Mailing Address C,ly Zip Phone <br /> H <br /> O H 5 Owner <br /> Applicant Mailing Aodress C- Zip Phone <br /> 1-4 <br /> ey <br /> ,moo <br /> Describe Proposed Work Construct new Single family residence _ <br /> I•e . <br /> H <br /> rA <br /> H <br /> '-r Project Address(if known) Int 18 of Powder Mill 1jigh1wridn2l011��_s2• •� sr _SI-V <br /> fill <br /> zHti <br /> 13 O N Attach four(4)copies of plans for proposed work-Draw to scale and note the following as applicable'. <br /> a Property Lines a Centerline of street / <br /> a Outline and dimensions of all existing and a Indicate North v <br /> proposed structures on the lot a Show any proposed grading changes <br /> a Existing and proposed utilities a Show measurements <br /> ' 'a DO NOT WR11E BELOW iH13 LINE O <br /> PERMIT CONDITIONS <br /> . All calls for In5PeClI0n shall be made 24 hos it.advance•phone 259.8810. <br /> onset.�7 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.Call Location Underground Service 48 hos before you dig TOLL FREE NUMBER 1.800.424.5555. <br /> t 4. In-tall roct, constrlactlon entrance behind driveway as per cit. <br /> standard 0203 and erosion control as directed by Public Works o <br /> Inspector. <br /> 5. Ki:ep city streets lean at all times <br /> b. Curb gutter and ciuewal ten the plat are new and undamaged . <br /> -am AW any damage t.heretn shall he replaced atthe discre`.ion of e.11..- <br /> Faisal <br /> Public WorFs Insp ,ctor. <br /> ` 7. Any change in t'tf- driveway cut must be approved by the PW In <br /> specter, wi.dt:h at prop line limited to existing apron width. <br /> A. Cnnnect all roof . yard and driveway drains to storm drain <br /> systam provided to lot. <br /> 9. Adiust water bo;<es to grade at end of construction. <br /> ��► 10. Driveways shall be completely cured before driving on thele, <br /> i ACKNOWLEDGEMENT OF CONDITIONS <br /> s <br /> "t The undersigned ownerlapphcnnt hereby agrees to hold and save harm. <br /> //))---- Tess the City of EVel Olt Irons any and all clalvs for damages, coal& <br /> expenses.maim n nausea of imam that may other because of installation <br /> sehrto <br /> � and maintenance of the Improvement or other right-of-way use hereto <br /> applied lot and further agrees to remove same upon notice from the <br /> Approved for ConstirWlilln /' Date City and to replace public properly damaged thereby. <br /> 61 Al Ja 2- <br /> FINAL INSPECTION Date cY—�` LAo <br /> Approved as Constructed Slgnalt e I Applicant DAI@ <br /> PUBLIC Yi DEPARTMENT WORK TOFHORIZEDDATE BY THIS PERMIT MUST BE STARTED WITHIN <br /> 150 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER I5 TO <br /> 3200 Cade,Street BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> EV01e1L WA,18201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259•t910 PROJECT OVER 90 DAYS DURATION <br />