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r � <br /> I <br /> jd <br /> � r <br /> H DatePohw worxr Parmnri 3i <br /> Bldg crier a 91/27422 <br /> i•pp L,.�linm 1 nr <br /> PUBLIC WORKS PERnMIT wsT tel ree z <br /> X T 1 7 total Fee ,y <br /> 1 t )STI N\T.. JPI) �a� Lnr bor Fac Pole! <br /> f—�J f <br /> j n Balance oue $7&0 <br /> Print or Type Only <br /> oo�yi 0 <br /> �U H ri G rT <br /> z Select Homes 237 Elm St Everett 98203 158-1503 <br /> Owner Melling Address City Zip Phone y <br /> nt O Owner <br /> L" O APPlicdnt Mailing Address City Zip Phone <br /> y <br /> i <br /> rxed o <br /> P <br /> ib —_- _ <br /> Descre Proposed Work New SFR 1250 SF t <br /> � <br /> O to <br /> n p y <br /> [Q9 r LU <br /> m Protect Address fit known) 102 60th P1 SE L o l r+ 14 In V ' <br /> Attach four(4)copies of pians for proposed wrrk-Draw to scale and note the following as applicerlile: <br /> • Property Lines • Centerline of street / <br /> • Outline end dimensions of all existing and • Indicate North v <br /> proposed structures on the lot • Show any proposed grading changes <br /> • Existing and proposed utlllties • Show measurements M <br /> DO NOT WRITE BELOW THIS LINE W <br /> �I PERMIT CONDITIONS <br /> 1.All calls for Inspection shall be made 24 fire in advance-phone 259.8810. <br /> 2.All work shall be performed in accordance with this permit and current City of Everett Design end Construction <br /> Standards and Specifications. <br /> i 3.Cell Location Underyrcund Service 48 hra,before you dig.TOLL FREE NUMBER 1.800.424.5555. <br /> r 4- Install rock construction entrance behind driveway as per city <br /> �) y standard 0208 and erosion control as directed by Public Works <br /> Inspector. <br /> 5. Keep city streets clean at al.l times <br /> i 8. Curb gutter and sidewalk in the plat are new and undamaged, lealas <br /> i any damage thereto shall be replaced at the disr.ration of. the I_ <br /> yam, Public Works rnapector. v, <br /> 7. Any change in the driveway cut must be approved by the Public <br /> Worka Inspector. <br /> Q' 8. Tightline all roof, yard and driveway drains to storm drain <br /> stubs at back side of sidewalk. <br /> 9. Adjust water boxes to grade at end of construction. <br /> 10. Driveways shall be completely cured before driving on them. s <br /> I�� t <br /> .g <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> js <br /> The underaignedowner/applicant hereby agrees to hold and save harm. t4 <br /> -- less the City of Everett from any and all claims for damages, costa •r <br /> Iexpenses, or causes of action that may arise because of Installation <br /> ��� Q and maintenance of the improvement or other right•ur•way use hereto <br /> .� FaAA-zrAA t: r <br /> yY 1 �yp.i C7—t(o—el1applied for and further agrees to remove same upon notice from the r. <br /> Approved[or Coqpruction Date City and to replace public property damaged thereby. <br /> -3 _ AG Q 8 b(/ <br /> FINAL INSPECTION Date <br /> Approved as Constructed Signature of App cant We <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 B020t BE DILIGENTLY PURSUED TO COMPLETION,THIS PERMIT MAY BE <br /> Phone: WA 9810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br /> r <br />