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Date�1C�� <br />ApPliwlion For <br />PUBLIC WORK ; PERMIT <br />Print or TypP Only <br />�� ��.�.. v. ,�.s r,.,m�� . ��� ����:J��,. <br />� ac Un�.,� • n/ /d �Y b r�--- <br />—�" _. . <br />1`uLi�c WoiM F oe <br />tolx�fee S __ <br />l�ssRpn' fpe Pnm S _ <br />��l'All�.l! I1uP S �, <br />���� � � �� �� <br />Aoplicanl Mailinq AAAress City Zip Phone <br />Descri6e Proposed Work / �� �w , � � (—v t �% � <br />Pmiecl Address lil knownl � GZ`- __ %t L� St. �b../ <br />Atlach !ow I�I copies of plans lor proposrA work � Draw to scair and note Ihe IpIIOWIfI(1 85 .lp{lhf.BblC <br />J Properly Lmes <br />• Oullino and d�mensions of nll e.istrnq anA <br />p�oposed structures on the lot <br />• Etlsting and proposrd util�lles <br />� CI?f1�t`f�if1B J� S�fCC� <br />• Indir.ale Noilh <br />• Show any proposed gi.iAin9 ch:�nqes <br />• Show mcaswements <br />PERMIT GONDITIONS <br />1. All calls for mspection shall Ge made 24 hra m edvance � phone 259•8810. <br />2. All work sh+ll be pedormed in accordance wilh Ihis permit and c�rrent City ot Everen Design and Conslruclion <br />Standerds and Specitications. <br />3. Call Locetion Underground Service 4D hrs. bebre you dia. TOLL FREE NUMBER 1•800-424•5555. <br />4_ IneY.nll. ror.k conatrur_tion entrance behind drivewey AO per city <br />et�nd��rd q7.OH to reduce trnckinp mud �nt:o ptreete and e�oAion <br />5 <br />8 <br />7 <br />� <br />9 <br />10 <br />contro7 .�t� di rr.r.Y.ed by Puhl ic Wo�^ke In��pnetor. <br />Re�p city etreete clean at a7] Y.imea. <br />Curb, �uY.Y.�r and ei.dAwnik in the pl.et erc� nc�w and undamag9d, <br />any dAmage thoroto ahall bc3 repinced nt the discretion of the <br />Public Worke Inepector. <br />Any chaneQ in Y.he drivoway cut muet be apprnved by the <br />F��blir. W�rke 7neper.Y.or_ <br />Ti�htline all roof, yard and dri.vewt�y drnine from houneo to ator <br />drain atube AL hAC� of Rfde wnik with rubber QABICffi P_V.C_ pi�_ <br />�� _ <br />� V�1 ` �.�. 1- zc�; —y i <br />Apprnvrd lor ConsVi c� Date <br />� � -,r�- s-� _ <br />FINAI. �NSPfICTION Date <br />Approvod as Consirucled <br />rvr�ri� PUBLICWORKSOEPARTMENT <br />� 3200 Codnr Slreet <br />[vore0. WA 98201 <br />Fhone�.259�BB10 <br />Y.hem. <br />ACKNOJJLEGGEM[NT OF CONDITIONS <br />W <br />� <br />� <br />/�� <br />V♦ <br />O <br />a <br />The unAersq�ned own-�Unpplir.an� harohy agrees lo hold nnd savr harn�- <br />less Ihe City ol Everetl Irom any antl aG claims foi dnmages. r.osl�: <br />exp�nses, or r.auses Of aclion Iha� may anse because ol Insiallahon <br />and mainlenance ol �he improvnmem or other ngh4obway use herrrlo <br />applieA lor anA lurlhm agrees In remove same upon notice Irom Ihr <br />Gty nnA �o mplace put�lic property damaged Ihere6y. <br />S an durc n�phc��`��� Date <br />aH AUiHOR17ED BY THIS PERMIT MUST BE STARTED WRNIN <br />1 DAYS Of OATE F[RId1T IS ISSU[D AND THEREAFTER IS TO <br />E DIUGf NTLV PURSU[D i0 COMPLETION THIS PERMIT Mf�Y OE <br />CANCELLfD BV iHE CITV UPON ANY STOPPl�GE OF WORK ON THIS <br />Pf,OJEC'. OVGR �10 DAVS flUfaATIOfJ <br />