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Date 7131_/9). Pini-c Wmq lie ` k/3z <br /> Aplil,'bon for To POSTING 3 LL, - nUy per, At 91/27450 <br /> PUBLIC WORKS PERMIT Pnlm wdr..rn <br /> H iobl fee <br /> C? Le6App1 roe Pod d <br /> 9Hr~if r <br /> �r Print or Type Only _{ o eeadce File If 9!2— <br /> �4 0 , o ,. r <br /> H 0 M <br /> � 1`A <br /> !, 11 .1 M r <br /> .� y Select Homes Inc. 237 Elm 1`5 Everett 08203 u v " 258-1503 <br /> H Owner mailing Adtlraggr- 'r u�11 1n r� p ZIP Phone <br /> LJ CJ O <br /> Cis 2 Owner C' r, %j `� r <br /> 61 <br /> = O Applicant Mailing Address City Zip <br /> Phone <br /> 04 n <br /> yz H Desl rroe P•cposed Work Oonatruct new SFR <br /> t" <br /> rA H <br /> nC)r <br /> � _ <br /> Project Address til known) '60th P1 CR MOT 71 <br /> H 0 N Attach four(4)copies of plans for Proposed work•Draw to scale and note the following as applicable. <br /> aaasf <br /> al Property • Centerline of street <br /> • Outline andnd dimensions of all existing and • Indicate North <br /> proposed structures on the lot • Show any proposed grading changes <br /> • Existing and proposed utilities • Show measurements <br /> DO NOT W141TE BELOW THIS LINE W <br /> PERMIT CONDITIONS O <br /> ' 1.All calls for Inspection shall be made 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 <br /> Standards and Specificallons. <br /> 3.Call Location Underground Servjce 48 lura.before you dip TOLL FREE NUMBER 1.800.424.5555. <br /> 4 . In_I;,J l 10Cl rOf'sII r on 0ntr uz <br /> sf:andard q?uy and ero<_lnn inn Pr nl [rv. <br /> Inspector-, <br /> ...� S. R'ep 1`.i tv el'-1`c>etG rledn t all f <br /> t mer, <br /> 6. Curb at,tfer and sinew >1f in tlu pl r n'w rod nn l ;maq��d, <br /> any damatn= fher'tn sh-til 1n, rr_plas,.i al_ the dim ,-r t 1n of tht_ <br /> ' Publir Works 1n pr+ct:,it . 'w <br /> 7. Ami champ+ .ill thedri vela., int V, <br /> mus_f hr apf,rnvell h•, the Fnhl 7 c <br /> Worts Inspector. O <br /> '.� H. Ti.ahtli.ne all r-r:,nf . varrl acid (it ivewa•: drains to storm d1' ai.n <br /> sti.lbs at bac{ side of ssid'welf . <br /> 7. Adiust: water, btra:,s to 'rade at 'Fill of construe lion. <br /> U7. Orivnwayscompl't�ly 7111`00 hint-' dr-i :•ina on them. <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> U1 The undersigned ownertapplicant hereby agrees to hold and save harm <br /> •+ -- less the City of Everett Iron any and all claims for damages, coals, <br /> expenses. of causes of actun that may arise because of Installation <br /> 8 -pJ� and maintenance of the improvement or other right•ol-way use hereto <br /> Approved for Const 11 Date applied for and further agrees to rem Iva same upon notice from the <br /> Cily o re lap public pfopepqjamaged thereby. <br /> FINAL INSPECTION Date !n'QedfL_'_ <br /> Approved as ConslructetlSignature Of Applicaa,-e <br /> PUBLICWORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200 Cedar Street 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett WA 99201 BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Phone.269.8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />