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Date514/92_ <br />Application For <br />PUBLIC WORKS PERMIT <br />Public WOMB Permil <br />Bldg Dell • �Fj§9B <br />Pubb- WmM Fee i Toixl Fee <br />Lees Appl. Fee PUC <br />Print or Tyrle Only IO POSTING- 5-1- 3 I aelelpaDua : 2� <br />Abode Ltd_ 18404 - 104th Ave NE Rethn110 WA oarnT 487 �868 <br />Owner Mallmg Address City Zip Phone <br />Owner <br />Applicant Mailing Address City Zip ,In,. n_„J_,� Phone <br />°?6 S10 <br />Describe Proposed Work Onnatrrlct- no, duplex <br />Jai <br />Project Address (if known) fr..t 9 of cp 9—aa),- <br />Attach lour (4) copies of plans for proposed work - Draw to scale and noto the following as applicable: <br />• Property Lines • Centerline of street <br />• Outline and dimensions o1 all existing and • Indicate North ..') <br />proposed structures on the lot • Show any proposed grading chnng,es <br />• Existing and proposed utilities • Show measurements <br />PERMIT CONDITIONS SfCH i-L.50 <br />1. All calls for inspection shalt be mode 24 his. in advance- phone 259.8810. DiV'PI 110. 00 <br />2. All work shall be performed in accordance with this permit and current City of Everett Design, �2p�uctfon <br />Standards and Specifications. <br />3. Cell Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1.800.4mmnSit � 1.00 <br />4. Install rock construction entrance behind drive `d per city <br />standard #208 and erosion control as directed hV6%1 blil6-`QXiik,- <br />Inspector. BNDII s720.00 <br />5. Keep city streets clean at all times 1171/5 $949.00 <br />8. Curb gutte.• and sidewalk in the plat are new anWOPAWMnaged, <br />any damage tlereto shall be replaced at the dis?VaWion$Vf4he <br />Public Works Inspector. CHEC!•' $5901.00 <br />7. Any change in the driveway cut must be approved by the PW In- <br />spector, width at prop line limited to existing apron width <br />S. Connect all roof, yard and driveway drains to storm drain <br />system provided to lot. <br />9. Ad.iust water boxes to grade at end of construction. <br />10. Driveways shell be completely cured before driving on them <br />Approved for Construction Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett WA 98201 <br />Phone: 259.8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />LM <br />rrtstsw <br />O <br />b <br />O <br />''^� <br />V♦ <br />0 <br />a <br />The undersigned owner/applicant herety agrees to hold and save harm- <br />less the City of Everett from any and ell claims for damages, costs, <br />expenses. or causes of action that may arise because of installation <br />and maintenance of the improvement or other light of -way ups nuieio <br />applied for and further agrees to remove same upon notice from the <br />City and to replace l - roperty aged they by. <br />Signefure 61 Applicant Date <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 />