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i� /i-20-92 numcworhaPmmn• Z <br /> p uu .� Dula— 16420— <br /> Application <br /> N Application For <br /> PUBLIC WORKS PERMIT "°`r« �:`" • <br /> r{ (] Cosa Awt raa Paid Q <br /> O M k0� r 1 7_�I- <br /> 0 <br /> aauza DUP <br /> lt2�tlato M Print or Type Only TA n(1CT1��(i --- <br /> �a Countr ood Homes 14410 Bel-Red Rd. 0200 Bellevue 98007 644 <br /> N <br /> City Zip <br /> Owner Melling Address Phone-2323 <br /> N — <br /> N <br /> Angie Stevens <br /> QQQ y Owner City — - - a - Phase <br /> }{ C m <br /> Applicant Melling Address — — <br /> i, <br /> In y Describe Proposed Work <br /> new house <br /> Project Address(it known) <br /> 2730 59th St SW Lot 12 --- -- <br /> Attach four(4)copies of plans for proposed work•Draw to scale and note the following as applicable. <br /> �a <br /> • Property Lines • Cenlerline of-treat <br /> • Outline and dimensions of all existing and • Indicate North <br /> • Show any proposed grading changes <br /> proposed structures an the lot <br /> • Existing and proposed utilities • Show measurements im <br /> ,- DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS saas� <br /> 1.All calls for Inspection shell b•rnede 24 hrs.In advance•phone 259.8810. <br /> 2.All work shall be performed In accordance with this permit and current Cily of Everett Design and Construction <br /> 1 Standards and Specifications. .800.424z <br /> '� 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1 .5555. <br /> 4. Install rock construction entrance behind driveway As prrr rtl' <br /> standard 0208 And erosion control an directed by Public Warr <br /> Inspector. <br /> 5. Keep city streets clean At All timem <br /> 6. A1rb Rutter and sidewalk in the p1At, ars new and undamaged, <br /> any damage thereto shall he replaced At the discretion of the <br /> H1hl.ic Works Inspector. <br /> 7. Any change in the driveway cut must be approved by the PW In- <br /> spector. width At prop line limited to existing apron width. <br /> R. Connect nll roof, Yard And driveway drains to storm drain q <br /> system provided to lot. Ii <br /> 9. Adjust water boxes to grinds. at. Plid of. constnlrtion. <br /> 10. Driveways shell be enmpletely cured before driving on them. <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> _ �� The undersigned owner/applicant hereby agrees to hold and save harm. <br /> I loss 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 /> n . C I�Q� 1y and iedmaintenance <br /> and <br /> of the improvement or v other right-of-wayinotice <br /> use hereto <br /> I V l �— 14 I� applied for and ,wthar agrees to remove same upc' notice Irom the <br /> Approved for Cons ruction Dale City and to replace public properly damaged thereby. <br /> /•1 ./b. 4' L <br /> FINAL INSPECTION Date Dale <br /> Bignat a of Applicant <br /> Approved as Constructed WORK AUTHORIZED BY THIS PERMIT M ST BE STARTED WITHIN <br /> I 7 PUBLIC WORKS DEPARTMENT 180 DAYS 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:2598810 PROJECT OVER 90 DAYS DURATION. <br />