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i <br /> f1 <br /> A F-I <br /> f-3 CA <br /> FA (� <br /> 0 Date 1-14- 2 H�QI ?'! 1"OSTI NG e�:1^I`t f-- v.hh.work.F.,mN97 _. 9U 136/_ <br /> H y H <br /> Application For eas o.cr.. 92/35332 _ <br /> i y PUBLIC WORKS PERMIT NeTOLFs`" 9 <br /> Cx) n L.I.AMi F..P.Id - <br /> e~i Print or Type Only <br /> ZH r`Cap2i� <br /> �y 1'3 I'1 M ~ .w .A M M Gt <br /> y <br /> 8 Hanabrook Inc E. 4020 in S man "WA 99202 509 534-0644 <br /> p H Owner Mailinio Ail*# ; , CnY Zip Phone <br /> U CA <br /> C_ o q�q [S.5r c� " r 'Si.. - <br /> (� Owner sr 555� �ro :Ljac; `sc rr, �r <br /> 1-9 <br /> O y Applicant N.alling Address City Zip Phone <br /> Describe Proposed Work new SFR LOT 40 <br /> 2 <br /> Project Address lit known) 3 — G0714 PL SC L <br /> Attach Iov(4)copies of plans for proposed work-Draw to scale and note the following as applicable: sssr. <br /> • Properly Lines •Centerline of street <br /> • 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 <br /> �. DO NOT WRITE BELOW THIS LINE O <br /> i PERMIT CONDITIONS <br /> f 1.All calls for Inspection shall be made 24 hm.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 Specifications <br /> +�I 3.Cell Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1.800.424.5555. <br /> 4. Install rock construction entranr_e behind driveway as per city <br /> standard 0208 and erosion control as directed biv Public Works <br /> Inspector. <br /> + 5. Keep city streets clean at all times <br /> k 8. Curb Butter and sidewalk in the plat are new and undamaged. H <br /> [ any damage thereto shall be replaced at the discretion of the V♦ <br /> Public Works Inspector. <br /> +� 7 . Any change in the driveway cut must be approved by the Public O <br /> Works Inspector. <br /> r 8. Tightline all roof. yard and driveway drains to storm drain <br /> + ' stubs at, back side of sidewalk. <br /> 9. Ad.iust water boxes to grade nt end of construction. <br /> 10. Driveways shall be completely cured before driving on them. <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> ti The undersigned owner/applicant hereby agrees to hold and save harm- <br /> lose the City of Everett from any and all claims for damages crisis. <br /> (� expenses or causes of action that may arise because of Installation <br /> {r l C I and maintenance of the Improvement or other right-of-way use hereto <br /> — 3 ( IL <br /> applied for and further agrees to remove same upon notice from the <br /> Approved for Co uctlon Date City and to replace public property damaged thereby. <br /> 7 <br /> 6-r rL d �2 <br /> 1 INAL INSPECTION Date <br /> Approved as Constructed SIB ature of Applicant Date <br /> PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STA TED WITHIN <br /> 3200 Cedar Street 180 DAYS DATE PERMIT IS ISSUED AND THEREAFTER IS BE DILIGENTLY <br /> BTO <br /> E <br /> EvereILWA98201 Y PURSUED TO COMPLETION.THIS PERMIT MAY <br /> Phone:259.8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br /> —_ i <br />