Laserfiche WebLink
Date_ 6-'5-70 <br />_ _ <br />Application For <br />PUBLIC WORKS PERMIT <br />Ptint or Type Only <br />Public Works Pli a 90�31 S <br />Bode Dept a 90/24958 <br />Pubee Works re, -_-- <br />Totall ree • <br />Less AP, l Fee Paid S <br />Balance Due <br />8 ,)O 00 <br />Stcaing homes NW 12407 Mukiltec, Speedway Lynnwood 98037 742-6544 <br />Owner Melling Address City Zip Phone <br />Owner <br />Applicant Mailing Address City <br />Describe Proposed Work New-GF-R e,l __ .— <br />Phone <br />At-13 <br />Project Address (if known) T70g - 63rd At_ 3e <br />W <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the following as applicable: <br />s>_ <br />• Property Lines • Centerline of street <br />/ /\ <br />• Outline and dimensions of all existing and • Indicate North <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 <br />CONDITIONS <br />O <br />PERMIT <br />1. All calls for Inspection shelf 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. Call Locatlor Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1.800-.174.5555. <br />Z <br />4.APPLICANT SHALL INSTALL INFILTRATION TRENCH, (16 CU. FT. MINIMUM <br />FILLED WITH DRAIN ROCK1 AND DIRECT ALL DRIVEWAY AND ROOFTOP DRAINAGE <br />KcrtA <br />Approved for COnstyftlon Dale <br />FINAL INSPECTION <br />Approved as Constructed <br />PUBLIC WORKS DEPARTMENT <br />3200 Ceder Street <br />Everett WA 98201 <br />everetl <br />Phone: 259.8810 <br />��r <br />V/� <br />♦ <br />O <br />00o Axxa <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned oener/applicant hereby agrees to hold and save harm• <br />less the City of Everett from any and all claims for damages. costs <br />expenses, or causes of action that may arise because of installation <br />and maintenance of the improvement or other right-ol-way use hereto <br />applied for and further agrees to remove same upon notice from the <br />City and to replace public property dap(eged thereby <br />uele <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />