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Na 1 <br /> i <br /> 9-27-91 wbb,W as Pe.pn <br /> Date TO POSTING z <br /> A � Application For env Dept.a 91/277 9 <br /> I~ PUBLIC WORKS PERMIT PeeT. rasr1e • <br /> Lev Alpt fee Pxns <br /> K 0 i' baa Dae d� <br /> o x O Print or Type Only <br /> HZri <br /> Select homes 237 Elm St Everetlo 91920*p25Lt-1503 .n <br /> t7 Owner Melling Addresti DAG Y!,^ Phone <br /> Owner <br /> c�. n <br /> a H Applicant Mailing Address City Zip Phone <br /> t" H <br /> t7 14 '3 Describe Proposed Work new SFR _ <br /> C) H <br /> C) 0 in <br /> y <br /> Protect Address(if known) Lot 16 1 2.7. - Go I:H R- SE — <br /> 1 Attach four 141 copies of plana for propocod work• Draw to scale and note the following as applicable: <br /> • Properly Linea •Centerllne of street ♦/� <br /> R • Outline and dimensions of all existing and • Indicate North v♦ <br /> proposed structures on the lot • Show any proposed grading changes <br /> • Existing and proposed utilities • Show measurements wA <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. 0 <br /> 1 <br /> 2.All work shall be performed In accordance with this permit and current City of Everett Design and Construction <br /> i Standards and Specllicatlois. <br /> _ 3.Cell Location Underground lervice 48 hire.before you dig.TOLL FREE NUMBER 1.800-424.5555. <br /> 4 . Install rock construction entrance hehind driveway as Per city <br /> I standard 11208 and erosion control as directed by Public Works <br /> j Inspector. <br /> 5. Keep city streets clean at all times <br /> I'I ! 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 /> j 7. Any change in the driveway cut must be approved by the Public <br /> Works Inspector. <br /> 8. Tightline all roof, yard and driveway drains to storm drain w <br /> stubs at back side of sidewalk. CIL <br /> I9. Adjust water boxes to grade at end of construction. <br /> �1 10. Driveways shall be complately cured before driving on them. <br /> `Ik ACKNOWLEDGEMENT OF CONDITIONS <br /> _ The undersigned owner/applicant hereby agrees to hold and save harm <br /> 071� lees the City of Everett from any and all claims for damages, coals. <br /> �Isl expenses. or causes of action that may arise because of Installation <br /> ,1 v e and maintenance of the improvement or other right-of-way use hereto <br /> M <br /> (t s C rvc0- L,—5 applied for and further agrees to remove same upon notice from the <br /> Approved for Con uc� Date City and to replace public properly damaged thereby. <br /> FINAL INSPECTION Date <br /> Approved as Constructed Signature of Applicphl Oate <br /> PUBLIC WORKS DEPARTMENT WORK AD BY THIS PERMIT MUST BE STARTED WITHIN <br /> 180 GAYSS OF TE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200 Cedar Street BE <br /> Everett WA 90201 BE DILIGENTLY <br /> DATE <br /> PURSUED TO COMPLETION.THIS PERMIT MAY <br /> BE off Peons:20B•0810 CANCELLED 8V THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br /> 1 <br />