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i <br /> /y 7 <br /> Public Works Per mClV *9 <br /> Application For eine Deft •_( <br /> PUBLIC WORKS PERMIT Pubke work,Fee <br /> Tolsl Fee 6 <br /> Les,APP)Fee Pein S __ <br /> Print Or Type Only Balance Due <br /> J1 Wit!- L� rl /� � <br /> caner Meiling Ad,r .ss City Zip UPhone <br /> Applicant Malting Addressss City Zip Phone <br /> Describe Proposed Work�� Z n—f —/— <br /> � __ � 2 -�,&� _ <br /> LU <br /> Project Address til known) 115 c.P 1ST Pt— 5E L <br /> Attach four(4)copies of plans for proposed work• Draw to scale and note the following as applicable: (�� <br /> 0 Property Lines 0 Centerline of street <br /> • Outline and dimensions of all existing and • Indicate North v♦ <br /> proposed structures on the lot • Show any proposed grading chanties <br /> • Existing and proposed utilities • Show measurements <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS Q <br /> 1.All calls for Inspection shall be made 24 hrs,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 /> 3.Cell Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1•800.424-5555. S <br /> 4.ANY CHANGE IN THE DRIVEWAY CUT MUST BE APPROVED <br /> BY THE PUBLIC WORKS INSPECTOR. <br /> 5.CONNECT DOWNSPOUTS TO PUBLIC DRAINAGE SYSTEM. <br /> B.KEEP CITY STREETS CLEAN AT ALL TIMES. �/� <br /> 9.ANY DAMAGE TO THE CURB AND SIDEWALK WILL BE REPAIRED V♦ <br /> TO THE SATISFACTION OF THE PUBLIC WORKS DEPT. ©^ <br /> a, <br /> ACKNOWLEDGEMENTCONDITIONS <br /> The undersigned owner/applicant hereby <br /> agrees ID hold and save harm- <br /> less the City of Everett from any and all claims for damages. coats. <br /> expenses. or causes of action that may arise because of Installation <br /> L and maintenance of the improvement or other righl•ol•wey use hereto <br /> Approved for ConstrE n Date _ applied for and funkier agrees to remove same upon notice from the <br /> City and to replace public property damaged thereby. <br /> FINAL PE I N Dale <br /> Approved ns Constructed Signature of Applicant Date <br /> r•vrrrtl PUBLIC WORKS DEPARTMENT WORK AUTHORI'ED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200 Cedar Street BE DAYS TL DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett,WA 98201 BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Phone:2 A 9810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />