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1 <br /> Date 9/27/91 �11 I"�\�I�lj --t rmc we w•re.en• �I � <br /> mds Deor • 91/27812 _ <br /> Application f"I <br /> H PUBLIC WORKS PERMIT PuEhc Wene Poe S <br /> y <br /> Lost <br /> fs i <br /> Lefe Pr fee Paidcl 5 <br /> y w Print or Type Only <br /> Ilanabrook Inc E 4020 Main Spokane 99202 534-0644 <br /> 00X00 Owner Mailing Address cnv Zip Phone <br /> �j " <br /> H 5C Applicant Mailing Address City Zip Phone <br /> tZI <br /> Min <br /> I"I O Descrihe Proposed Work New SFR Lot 42, Ilanabrook Div 111 <br /> ra]V <br /> - <br /> gyy W <br /> H <br /> dN z so - Caotj, i�.st <br /> Project Address(11 known) —- <br /> y rA Attach four(4)copies at plans for proposed work-Draw to scale and note the following as applicable. ssss� <br /> H 0 y O Property Lines • Centerline of street ♦^ <br /> • Outline and dimensions of all existing and • Indicate North V <br /> proposed structures on the lot • Show any proposnd grading changus <br /> • Existing and proposed utilities a Sbow n.rdsuvmrn!s M <br /> DO NOT WRITE BELOW IHIS t lrii <br /> PERMIT CONDITIONS <br /> 1.All calls for Inspection shall be made 24 hrs.in advance-phone 259.8810. ss^ <br /> sales 2.All work shall be performed In accordance with this permit and current City of Everett Design and Construction <br /> Standards and Specification& <br /> 3.Call Location Underground Service 48 hr&before you dig.TOLL FREE NUMBER 1.800.424.5555. Z <br /> 1� 4. Install rock construction entrance behind driveway as per city O <br /> standard 0208 and erosion control as directed by Public Works <br /> Inspector. <br /> 5. Keep city streets clean at all times <br /> eieft 8. Curb gutter and sidewalk in the plat are new and undamaged, <br /> any damage thereto shall be replaced at the disc etiorl of the ,w <br /> Public Works Inspector. V, <br /> Ii'0see,1 7. Any change in the driveway cut must be approved by the Public O <br /> Works Inspector. <br /> 8. Tightli.ne all roof, yard and driveway drains to storm drain <br /> stubs at back side of sidewalk. am <br /> seies �.� 9. Ad.iust water boxes to grade at end of construction. <br /> 10. Driveways shall be completely cured before driving on thein. <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agreer to hold and save harm. <br /> less the City of Everett from any and all claims for damage& coat& <br /> expense& or causes of action that may arise because of installation <br /> _ and maintenance of the Improvement or other right-of-way use hereto <br /> applied for and further a rees to rem Is some upon notice Irom the <br /> Approved Ior Construction Date City and to re u pro d t god thereby. <br /> .mac/c✓'<��� .) - Y y-- <br /> FINAL INSPECTION Date // <br /> Approved as Constructed nalun of plleant Difte <br /> PUBLIC WORKS DEPARTMENT WORK AUTHORIZED B H PERMIT MUST BE STARTED WITHIN <br /> PUBLICWScree! 180 DAYS OF DATE P IT IS ISSUED AND THEREAFTER IS TO <br /> Cff Ear 3200 Ceder 9 Street <br /> BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Phone1269 9820 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br /> a <br />