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2 <br /> Date 8/12/91 <br /> /12 91 R.bhcweik.P.mn. 91I3o5 <br /> Application For Ride Dept . 91(27521 <br /> PUBLIC WbRiKS PER I '7`cw"Fea <br /> T(15TI N G __ as Total res s <br /> OLae.Hopi Fee Pe'd $ <br /> Print or Type Only `r3 8 R 8 8 E3 8 8 59 e.i.e sous s Lo <br /> � <br /> v�}ioMCA p0} 0 ohm <br /> ti M h N H m <br /> Select Homes, Inc. 237 m St. o Ev�ete, 9(1103 258-2503 <br /> Owner .?Mei AddreeaS o C, I Zip Phone <br /> Owner o a' m o n r7l : r Iry <br /> Applicant Melling Address City Zip Phone <br /> Describe Proposed Work ConetrUct new SFR <br /> i <br /> 1 D 11 <br /> Project Address(If known) Aft - 60th PI E p} <br /> �l V <br /> Attach four(4)copies of plans for proposed work- Drr v t I scale and n.•e the following as applicable: <br /> • Property Lines • Centerline of street <br /> • Outline and dimensions of al;existing and • Indicate North <br /> proposed structures on the lot • Show any proposed gradi!ig changes Lu <br /> • Existing and proposed utilities • Show measurements <br /> seer_ <br /> DO NOT WRITE BELOW THIS LINE Im <br /> PERMIT CONDITIONS O <br /> 1.All calls for inspection shall be made 24 hrs.In advance-phone 259.8810. 0 <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.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1.800.424.5555. <br /> 4. Install rock construction entrance btehind driveway as per city <br /> standard #208 and erosion control as directed by Public Works O <br /> Inspector. <br /> 5. Keep city streets clean at all times <br /> b. ;urb clutter and sidewalk in the plat are new and undamaged. <br /> any damaqe 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 O <br /> Works Inspector. <br /> 8. Tiohtline all roof . yard and driveway drains to storm drain 0 <br /> stubs at back side of sidewalk. <br /> 9. Adjust water boxes to oracle at end of construction. <br /> 10. Driveways shall he completely cured before drivincl on them. <br /> 1/y 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 /> (�_oJ' ;nd maintenance of the Improvement or other right-of-way use hereto <br /> @Fp applied for and further agrees to remove same upon notice from the <br /> Approved for Construction Date Cit a to replace public property erty damaged thereby. <br /> FINAL INSPECTION Date <br /> Approved as Constructed Slgnee of Applicant Date <br /> PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200 Cedar Street 160 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett,WA 98201 BL DILIGENTLY PURSUED TO COMPLETION.THIS PERMIr MAY BE <br /> Phone:2598810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF W-RK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />