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r <br /> Date_-9�-L-91 6S'6 y /° Public Work$PerMle <br /> BeesDep' •_ 1/2 7 <br /> Application Fol <br /> PUBLIC WORKS PERMIT P.1, <br /> OTotal FeeFea <br /> Leu APpr Fee Paid 8 'A <br /> Print or Type Only <br /> TO POSTING _ 3 aD qa Balance Due S ' <br /> Select (tomes 237 Elm St Everett 98203 258-1503 <br /> Owner Melting Address City Zip Phone <br /> Owner <br /> Applicant Mailing Address City Zip Phone <br /> Describe Proposed Work new SFR <br /> Project Address(if known) T t 9 �•8 " CoO th V�LSG _ F_ <br /> Artach lour(4)copies of plans for proposed work• Draw to scale and note the following as applicable: �o <br /> • Property Lines • Cer.tarlino of street ♦^ <br /> • Outline and dimensions of all existing and • Indicate North Y <br /> proposed structures on the lot • Show any proposed grading changes <br /> • Existing and proposed utilities • Show measurements <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1.All cells 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 o! Everett Design and Construction <br /> Standards and Specifications. <br /> 3.Call Location Underground Service 48 hrs,before you dig.TOLL F.7EE NUMBER 1•800-424.5555. <br /> 4 . Install rock construction entrance behind driveway as per city O <br /> standard #208 and erosion control. as directed by Public Works <br /> Inspector. <br /> 5. Keep city streets clean at all times <br /> 6. 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. Cn <br /> 7. Any change in the driveway cut must be approved by the Public O <br /> I Works Inspector. <br /> A. Tightli.ne all roof, yrrd and driveway drains to storm drain A <br /> stubs at back aide o. sidewalk. Lai' <br /> 9. Adjust water boxes to grade at end of construction. <br /> 10. Driveways shall be completely cured before driving on them. <br /> ACKNOWLEDGEMENT OF CONDI-IONS <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, cost& <br /> eypenses, or causes of action that may arise because of Installation <br /> and maintenance of the glees o remove <br /> or v other right-of-way useefr hereto <br /> eppll for and lurcher agrees to remove same upon notice from the <br /> Approved for Cost uction Date City d o ranlac ublic propel dammed thereby. <br /> FINAL INSPECTION Date Date <br /> Approved as Constructed Igna re of Applicant <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> PUBLIC WORKS DEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200 Ceder Street BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Everett,WA 08201 CANCELLED BY THE CITY UPON ANY ATOPPAGE OF WORK ON THIS <br /> Phone'259.8810 PROJECT OVER 90 DAYS DURATION. <br />