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Date—�25 ���j(LC%�`,^�' ��t <br />Applicahnn Fo� r- K ��� <br />r -. <br />PUBLIC WORKS P� �M911NG ��-�� <br />1� E'O�T�I� , <br />Print or Type Only r ..�, r- <br />� 3�f o.p p M p � p Cj <br />. «� M N U � y� M <br />Oakcrest Homes Inc 13712 64th <br />vnar Maihng Add <br />Owner <br />Applicant <br />Describe Proposed Work _ new house <br />rC55 <br />����3����'�'�� <br />���������� <br />Cily <br />Pmje-� Address Uf knownl pQ'/1KR�� � ����+7��*� <br />Atl.,oh four !4� copies ol Plans lor propoeed work � Draw to sr., le and note me lollowing as app6cable: <br />�� <br />• Property Llnes <br />• Out!ine and dimensions ol all exisling xnd <br />pro�osed siructures on ihe Int <br />• Existing antl proposed ulilities <br />PupLc Worxs Peimp • " • �_l—_ <br />e�nu onn� • �i6628------- <br />Punbc Wrrhsfee s �----.... <br />tol�l Fae -- <br />Les��oni �arn�n S _ <br />iBeia�cn0uc S �� _ <br />• CenlerGne ol street <br />• Indir.ate Norlh <br />• Show any proposed gradiny chenges <br />• Show measu�ements <br />W <br />H <br />� <br />� <br />� <br />PERMIT COND�TIONS � <br />t. All cells lor inspection shall be made 24 hra. In advence - phone 259•8810. � <br />2. All work shall ba peAormed In accordance with this permit and current City ol Everett Design ene Constructlon <br />Slenderds end Specilicetions. <br />J. Cell Locellon Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800•424•5555. � <br />t. List�ll rock constiuchon entrance behind dm�eway as per city standvd ti?08 and erosion conhol as d'ueeted by <br />}'ubiic Wo�ks Inspcctor. O <br />S. F:ctp cily sUc.is dcan n� a5 Wuc�. <br />6(iufi �ilter and sidewolk in thc pint nrc new nnd nndnma�ed, arry dam��e thereto shsll be roplaced at �he <br />disacliuu of We FubGc Wutks hi,peclo�. � <br />'. Arrv cha�igc u� thc dm•ea�ap c�d mi:st bc appro��cd by Ihc P�V 6ispcctor, width at prop linc timitcd to cxisting <br />npron tvidlh � <br />8. CwL fnce ihUuu ur oU�e� ,lomi dtain >wLs have beui piovidzd lo each lol u� lLe plat for Uie co�me�4on of O <br />rootTop downspouts. <br />a <br />Appro ed fo� Co uction � / � �� <br />w � � •aIy' J%! <br />FINAL I ECTION Datr. <br />Approved as Constructed <br />��PUBUC WORKS OEPA9TMENT <br />3200 Ceder S�reel <br />Everolt. WA 98201 <br />Phona:259�B810 <br />ACKNOWLEDG[MENT OF CONDITIONS <br />ihe undersigneA owneUapplicant hereby agrees to holA and save hann� <br />less tha Gdy ol Everelt Irom any and all claims lor damages. cosis. <br />ekpenses, or causes ol action �hat may arlse because of installnt�on <br />and malntenanr,e oi Ihe imp�ovemenl or other righl�obw�y use hereto <br />applied Inr and further agrecs to remove same upon notice Irom Ihe <br />Cdy antl lo replace publiC propeily damaqed thereby. <br />_ �1--- l-�-� <br />Signature ol APph� n� Date <br />WORK AUTHORIZEO BV TNIS PERMIT MUST BE STARTED WITHIN <br />180 DAVS OF DATE PEFiMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PUFSUED TO GOMPLETION. THIS PERMIT MAY 8[ <br />CANCELLED BY THE CITY UPON ANV STOPPAGE OF WORK ON THIS <br />PROJEC7 OVLR 90 DAVS DURATION. <br />