Laserfiche WebLink
A <br />Date 11 8 93 Yr: "n;wNGI <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Alyn homes <br />Owner <br />Same <br />Applicant <br />5416 140th P1 SE Everett <br />Describe Proposed Work <br />Mailing <br />98208 337-9272 <br />Mailing Address <br />New house - basic 235 <br />Project Address fit known) <br />Attach four (4) copies of plans for proposed work <br />Uly <br />Public Works Permit g3/503 <br />Bldg Deer • 42636 <br />u: Wads Fee S <br />Total Fee <br />Less Apo) Fee Paid S - � <br />salsace Due S <br />City Zip Phone <br />12.02- -13' q 1 <br />Draw to scale and note the following as applicable: <br />• Property Lines <br />• Outline and dimensions of all existing and <br />proposed structures on the lot <br />• Existing and proposed utilities <br />• Centerline of street <br />• Indicate North <br />• Show any proposed grading changes <br />• Show measurements <br />PERMIT CONDITIONS <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 end Construction <br />Standards end Specifications, per city <br />3. Standards <br />lpergr0ytions, M0'VfiL 4r0ypuu9ig$PhInE��i'l.4�� <br />standard 0208 and erosion control as directed by Public Works <br />Inspector. <br />5. Keep city streets clean at all times <br />8 ewalk in the plat <br />anyCurbdamage rthereto and dshall be replaced at thewdiscretion and aofdthe <br />Public Works Inspector. <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 />8. Connect all roof, yard and driveway drains to storm drain <br />system Provided to lot. <br />9. Adjust water boxes to grade at end of construction. <br />10. Driveways shall be completely cured before driving on them. <br />tiJW 15 `q3 <br />Approved for Construction <br />Date <br />'12 -r <br />D to <br />FINAL INSPECTION <br />Approved as Constructed <br />0 PUBLIC WORKS DEPARTMENT <br />3200 Cedar WORKS <br />Street <br />wn Everett, WA 98201 <br />Phone: 259-8810 <br />LU <br />N <br />co <br />0 <br />M) <br />z <br />0 <br />r <br />0 <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/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 />anf maintenance of the Improvement or other nght•of-way use hereto <br />ap I d for and furthe agrees to remove same upon notice from the <br />City nd to replace {Ablic propgrty damaged thereby. <br />Signature of Applicant f <br />AUTHORIZED,WORK PERMIT <br />180 DAYS OFDATE PERMIT ISISSUED AND THEREAFTER ISHIN TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON PROJECT OVER 90 DAYS DURATION STOPPAGE OF WORK ON THIS <br />