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i <br /> f 1, <br /> p � � I Data 9-12-Ai V.• 1—Z3•� Public Was Palma i <br /> J I <br /> A !3 ApplicApplicationon For BMa seri <br /> a 1/27992 <br /> PUBLIC WORKS PERMIT r.er,war.Fn <br /> H Lee.Appi Fee P.la III <br /> 1'G 0 Balance Due <br /> P M W Print or Type only <br /> Nb i <br /> 8� Select Homes 2.37 Elm St Everett 98203 258-1503 <br /> Owner Mailing Address City Zip Phone <br /> OH <br /> C? <br /> $ Owner <br /> H I Applicant Meiling Address City 21p I Phone <br /> H <br /> H Describe Proposed Work Nein SFA, 1250 SF <br /> 14H <br /> �Cal — --- W <br /> W Project Address(it known) 102 60th Pl ° <br /> Attach four(4)copies of plans for proposed work• Draw to scale and note the following as applicable: a� <br /> • Property Linea • Centerline of street <br /> 1 • outline and dimensions of all existing and • Indicate North V <br /> proposed structures on the lot • Show any proposed grading cl anges <br /> • f sting and proposed utilities • Show measurements wA <br /> DO NOT WRITE BELOW THIS LINE O <br /> C"' PERMIT CONDITIONS <br /> 1.All calls for Inspection shall be made 24 fire.in advance`phone 259.8810. <br /> ' 1� <br /> 2.All work shall be performed In accordance with this permit and current City of Everett Design and Construction <br /> 1 Standards and Specifications <br /> 1 3.Call Location Underground Service 48 his.before you dig.TOLL FREE NUMBER 1.800.424.55$$. a� <br /> 4. Install rock construction entrance behind driveway as per city <br /> standard #208 and erosion control. as directed by Public Works <br /> Inspector. <br /> 5. Keep city streets clean at all times <br /> 8. Curb gutter and sidewalk in the plat are new and undamaged, <br /> any damage 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 C) <br /> Works Inspector. <br /> 8. Tightline all roof, yard and driveway drains to storm drain pA� <br /> stubs at hack side of sidewalk. baa ra <br /> 9. AdiuFt writer boxes to grade at end of construction. <br /> I_ 10. Dri.vewnys shall be nnmpintely cured before driving on them. <br /> t <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm <br /> U11less the City of Everett from any and all claims for damages. costs <br /> ekpenses. or causes of action that may arise because of installation <br /> e��� and maintenance of the improvement or other right- use berate <br /> _ applied for and further agrees to remove aero uponn notice from the <br /> Approved for Construction Date City and to replace public property damaged thereby. <br /> FINAL INSPECTION Date ,G(PL F�I L <br /> Approved as Constructed Signature of App cant Date <br /> PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> PUBLIC WORKS <br /> 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 32000 da Btree BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:289•8810 PROTECT OVER 90 DAYS DURATION. <br />