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Byrn <br /> x / <br /> P,miswortPil0 <br /> i< O L1,e2/17/91-- - <br /> Application For, Bldg Dept e <br /> 91/27520 <br /> PUBIC WORKS PERMIT Pawm lFee Fee — <br /> � rnr.i Fe. • <br /> 19 TO PASTING test.pplFee Paid • <br /> C) O etlmre Due • <br /> Print or Type Only n <br /> z " <br /> Select domes, Inc-. 237 Elm St r.r Everett '18203 258-1503 <br /> r Cwner Maillnp AVdresr, „rnt� Q ,Zip Phone <br /> l t:1 CA Owner .r $ Sti <br /> Applicant Mailing Address City Zip Phone <br /> Z. O CA <br /> 30rA <br /> I <br /> Describe Proposed Work Oonatruct new SFR -- <br /> _ I <br /> 12) 1 W <br /> Protect Address 111 known) 40M — 60th P1 SE Lot 11 19 I VFass <br /> Attach four(4)copies of plans for proposed work•Draw to scale and note the following as applicable: <br /> • Property Lines •Centerllne of street p� <br /> • Outline and dimensions of all exisr'mp and • Indicate North v <br /> proposed structures on the lot • Show any pr)posed grading changes <br /> • Existing and proposed utilities • Show measurements saA <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS i <br /> 1.All calls for inspection shall be made 24 hra.In advance•phone 259.8810. o\ <br /> 2.All work shall be performed in accordance with this permit and current City of Everett Design and Construction <br /> 1 Standards an.:Spe:fficatlons. <br /> 3.Cell Location Underground Service 48 his,before you dig.TOLL FREE NUMBER 1.800-424.5555. Z i <br /> `� 4. Install rock construction entrance behind driveway as per city <br /> standard 0208 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 v <br /> ='= Works Inspector. O <br /> 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. <br /> A ACKNOWLEDGEMENT OF CONDITIONS <br /> L'i 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 /> expenses, or causes of action that may arise because of Installation <br /> n ��¢ _1�,.pJ1 and applied <br /> for and <br /> of the improvement or v other right-of-waynnotice <br /> use hereto <br /> applied for and lunher sprees to remove same upon notice Irom the <br /> Approved for ConoXdtion / Dale City and to replace public property damaged thereby. <br /> FINAL INSPECTION Date <br /> Approved as Constructed Signature of ApIplicant Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> PUBLIC WORKS DEPARTMENT <br /> PUBLIC <br /> 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200 Cedar 98201 tree BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> ra Phone:289.8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />