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F, <br />[a � <br />AtHn <br />9 0-3 W <br />r <br />HEX <br />H= <br />Q M "QC <br />�G rA H�-r <br />[+1 O s <br />O H C7 <br />Y• e <br />>�>y <br />rHH <br />to <br />O ty fn <br />3W <br />Oy <br />Date s,1q/J92..- <br />Appticatmn Far <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />IN <br />TP "nCTING�_'L-43 <br />Pubrm Wg,•e Pemn • � �� <br />Bldg Nor • i6SQ1 <br />Punic Woae Fee S <br />role l Fee <br />L•ee Apol Fee Puda —... <br />Berenpe Due s16L <br />Abode Ltd. 1r,,04 - 104th AVe NE Bothell WA 98011 487-2868 <br />Owner Mailing Address City Zip Phone <br />Owner <br />Applicant Melling Address City Zip <br />Describe Proposed Work construct new dual ax -- <br />Protect Address of known) XX OF SP 2-891 _ <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the following as apphrahir <br />• Property Lines • Centerline of shag <br />• Outline and dimensions of all existing and • Indicate North <br />proposed structures on the lot • how any proposed uraoinq changes <br />• Existing and proposed utilities • Show measurements <br />Phone <br />' �1 <br />DO NOT WRITE BELOW THIS LINE - <br />PERMIT CONDITIONS <br />1. All calls for Inspection shall be made 24 hrs. in advance. phone 259.8810. <br />' <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and Construclior� <br />� <br />Standards and Specifications. <br />Service 48 hrs. before you dig. TOLL FREE NUMBER 1.800.424.5555. <br />3. Call Location Underground <br />4. metal] rock construction entrance behind drivPWAV nn ver rite <br />standard 020A and erosion control as directed by Public Works <br />Inspector. <br />5. Keep city streets clean at all times <br />6. Curb gutter and sidewalk in the plat are new And und-inineed. <br />_ <br />any damage there-.o nhall he replaced at the discrFtion of the <br />PublIn Works Tnspectnr. <br />7. Any change in the driveway cut must he approvrri by 1"r-- Ir <br />spector. width at prop line limited to existing nrr,ri wf <br />A. Connect all roof. vArFt and driveway drains to nirvm drain <br />system provided to lot. <br />9. Ad,iust water boxes to grade at end of r"onstrurtlrrn. <br />10. Driveways Snell be r-ompletely cured before driving un them. <br />I <br />wet <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />Phone: 259-8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />Z <br />0 <br />The undersigned owner/applicanl hereby agrees to hold and save harm- <br />less the City of Everett from any and all claims for damages, Coals. <br />expenses, or causes of action that may arise because of Installation <br />and maintenance of the improvement or other right-of-way use hereto <br />applied for and further agrees to .mope same upon notice from the <br />City and to replace publi or <br />Sign ure of ppllcant Oale <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 />