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0000 - s P s,ta�t;>wn;.a;etyc. <br /> Date.- ,a-12-91 TO IfO ST I N G __ Public Works Pormg l � � ,3Z V <br /> -- 91/27524 <br /> .• ; <br /> Application For alAa Oeot <br /> r,, <br /> PUBLIC WORKS PtRMIT Pub lic Total : _ <br /> Lose eppL Fee Pell S_///� <br /> I[�7 O O O U 8O nee Due <br /> Print or Type Only r_ tl G O p Lryr} <br /> t NNc1 p O Ln O [`- VI <br /> M Mee CA w mar, <br /> fJ <br /> Select Homes 237 Elm St Everett 9EJJ03 In a 258-1503 <br /> Owner Nailing Address m Ity_ RI RI yy�l Phone <br /> f Owner <br /> 1 Applicant Mailing Address City Zip Phone <br /> Describe Proposed Work new SF'R- 1250 SF _ <br /> 1 <br /> W <br /> Protect Addru111 Fnth PI SE Loss(it known) r <br /> Attach four(4)copies of plans for proposed work- Draw to scale and note the following as applicable: <br /> o Property Lines • Genterline of street r^ <br /> • Outline and dimensions of all existing and • Indicate North Y <br /> proposed structures on the lot • Show any proposed gl;ding changes <br /> • Existing and proposed utilities • Show measurements 00 <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1.All calls for Inspection shall be made 24 hrs.in advance-phone 259.8810. <br /> 2.All work shall be performed In accordance wi" this permit and current City• ,Everett Design and Construction <br /> fill <br /> Standards and Specifications. <br /> 3.Cell Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1.800.424.5555. z <br /> 4. Install rock construction entrance behind driveway as per city O <br /> standard #209 and erosion control as directed by Public Works <br /> Inspector. <br /> 5. keep city streets clean at all times <br /> 6. Curb clutter and sidewalk in the plat are new and undamaged. <br /> any damaqe thereto shall ye replaced at the disc, etion of the 'w <br /> Public Works Inspector. V, <br /> 7. Any change .in the driveway cut must be approved by the Public_ o <br /> Works Inspector. <br /> 8. Tiqhtline all roof. yard and driveway drains to storm drain <br /> stubs at back side of sidewalk . <br /> 9. AdJust water bones to oracle at end of construction. <br /> 10. Driveways shall be completely cured before drivinq on them. <br /> 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, coats, <br /> expenses, or causes of action that may arise because of Installation <br /> and maintenance of the Improvement or other right-of-way use hereto <br /> applied for and further agrees to remove same upon notice from the <br /> Approved for Construct/ion Date City ad o rept ce pu lie property damg� ed thereby. <br /> 7—/6 -y7 — <br /> 91 <br /> FINAL INSPECTION Date — Date <br /> Approved as Constructed Signal re of App icant <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> PUBLIC WORKS DEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER 13 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:269-8810 PROJECT OVER 90 DAYS DURATION. <br />