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1 <br /> _•_ - .u .. �"mol?mrl�aeb;4�aZ+,�, .atwar+e;�bw . <br /> i -za-q- <br /> ')ate 8'12-91 Public Works Permit 3 <br /> �� <br /> it <br /> Application For Bldg Dept a 91.27526 <br /> PUBLIC WORKS PERMIT Pubbc Works Fee <br /> TOTotal Fee a <br /> POSTING Less appt Fee Paid s <br /> Print or Type Only .Due s ZD <br /> Select Homes 237 Elm St Everett 98203 258-1503 <br /> Owner Mailing Address City Zip Phone f <br /> Owner <br /> Applicant Melling Address City Zip Phone <br /> Describe Proposed Work New SFR <br /> t <br /> UJ <br /> Protect Address til known) ( Z ' 60th PI SE SIV <br /> Attach lour(4)copies of plans for proposed work- Draw to scale and note the following as applicable: <br /> • Property Lines • Centerline of street <br /> • Outline and dimensions of all ex.•ting and • Indicate North <br /> proposed structures on the lot • Show any proposed grading changes <br /> • Existing and proposed utilities s Show measurements <br /> { DO NOT WRITE BELOW THIS LINE <br /> O <br /> PERMIT CONDITIONS I <br /> I 1.All cella for Inapectlr, ,shall be meds 24 his.In advance-phone 259-8810. <br /> 2.All work shall be performed In accordance with this permit and current City of Everett Design and Construction A <br /> Standards and Specifications. <br /> ! 3.Call Location Underground Service 48 his,before you dig.TOLL FREE NUMBER 1.800424.5555. <br /> 1 4. Inrstall roc! if <br /> standard #2( driveway as per city <br /> Inspector. <br /> :ted by Public Works O <br /> 5. Keep city at <br /> 8. Curb gutter few and undamaged, <br /> any damage t Is dini-retion of the <br /> Public Works <br /> 7. Any change i " <br /> Workb Inspec troved by the Public O <br /> stubs <br /> 8. Tightstubs ate a] ns to storm draiat bac n <br /> 9. Adjust water an <br /> truction. <br /> 10. Driveways Shall be completely cured before driving 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, costs. <br /> Q expenses, or causes of action that may arise because of installation and maintenance of the improvement or other right-of-way use hereto <br /> Approved for G Construct 0 / applied for and further agrees remove same upon notice from the Date City and to replace public property damaged thereby. <br /> �t311` <br /> FINAL INSPECTION Date t AP <br /> Approved as Constructed Sig a u Applicantl Date <br /> 41LPUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200 Cedar Street 180 DAYS OF DATE PERMIT IS ISSUED A14D THEREAFTER IS TO <br /> Everett WA 98201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone:259.8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />