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Mile <br /> rn reopen <br /> 40 <br /> t' H3W <br /> t0' 011Date 1-14— 2 Ar'T"'n / �j�.. Public wool Perm"• / <br /> TO I'1.1 <br /> H Apnh:at Fm / aidd Dept <br /> PUBLIC WORKS PERMIT Pubfo� r~ <br /> Fee . <br /> O r• u Leu 1,01 fee Peldd <br /> 6 f� p n eeb :a a, <br /> H� n Print or Type Only pp.. I� g In i $ 8 8 tis —m_Due <br /> 99 <br /> y <br /> t" N M N ~ O N MN Yn <br /> H 1,3 Hanabrook Inc " E.[i4020 Mainpok�Tle WA" 99202 (509) 534-0644 _ <br /> N <br /> H Owner mqIBng Addreaa �2 v KYr ._ ZIP Phone <br /> pglTl ��-+l ci` � a F� <br /> h7 Cx1 Owner �;'S a r fill I, =8 x <br /> xe3 Cn Applicant Melling Addreas City '-IP Phone—� <br /> H O to <br /> Describe Proposed Work new SFR LOT 39 <br /> Project Address(if known) 5 GO T-H. PL SE W <br /> Attach four 14)copies of plans for proposed work•Drew to state and note the following as applicable: r� <br /> • Property Lines • Centerline of street ♦^ <br /> • Outline and dimensions of all existing and • Indicate North M♦ <br /> proposed structures on the lot • Show any proposed grading changes <br /> • Existing and proposed Willies • Show measurements <br /> �� DO NOT WRITE BELaw T W THIS LINE <br /> PERMIT CONDITIONS <br /> 1.All calls for inspection shell be made 24 hr&In advance•phone 259.8810. <br /> 2.All work shall be performed In accordance with this permit and current City of'iverelt Design and Construction <br /> letter Standards and Specifications. <br /> exile me,,,I 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1.800.424.5555. <br /> 4. Instal.]. rock construction entrance behind driveway as per city <br /> standard 0209 and erosion control as directed by Public Worke <br /> Inspector. <br /> lei 5. Keep city streets clean at all times <br /> 8. Curb gutter and sidewalk in the plat are new and undan'aged, <br /> any damage thereto shell he replaced at the discretion of the <br /> Public Works Inspector. <br /> �. ..� 7. Any change in the driveway cut must be approved hY the Public O <br /> Works Inspector. <br /> B. Tightlins all roof, yard and driveway drains to storm drain <br /> Cl <br /> stubs at back side of sidewalk. W <br /> . 9. Ad.iust water boxes to grade at end of construction. <br /> 10. Driveways shall be completely cured before driving on them. i <br /> 1 I <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> (J!� The undersigned owner/applicant hereby agrees to hold and save harm. <br /> less the City of Everett from any and all claims for damages. coat& <br /> expenses, or causes of action that may arise because of Installation <br /> and maintenance of the improvement or other right-ol•wny use hereto <br /> Approved for consir to / Dale applied for and ce pubher agrees to remove same upon notice from the <br /> GCity and to replace public property damaged thereby. <br /> 11 ol�-r- y <br /> FINAL INSPECTION Date �- <br /> Approved as Constructed <br /> Signattire of Applicant Date <br /> CLPUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STA ED WITHIN <br /> 3200 Cedar Street 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett WA 98201 BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Phone:259.8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />