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�H� <br />O=Q <br />"i1 N ">r <br />y H <br />z <br />a tv <br />h"•i M O <br />O- n <br />9H� <br />gy <br />H <br />C Cy �N <br />H It) <br />H OD1 <br />Publm W014, Pormd <br />Date— -_t�G <br />aid, e.P1. . <br />Ap pbctihnn For <br />PUBLIC WORKS PERMIT ^imw° To ei °• <br />Fe, <br />Le„.Ppl Fee P.id 6 <br />B.bime Due >i � � <br />Print o1 Type Only <br />to ot)ka"t-( Vyhl kI-y: (LU CON <br />Mailing Address City <br />Applicant Mailing Address City Zip Phone <br />/ / <br />Describe Proposed Work •L/r-ZJ S1: - Io ---- <br />— — <br />W <br />1 B %E;t h e S\V <br />Project Address (it known) <br />Attach four (4) copies OI plans for proposed work • Draw to scale and note the following as applicable. <br />r• <br />• Properly Lines • Conterlme of street <br />/^ <br />U) <br />• Outline and dimensions of all e.istmg and • Indicate North <br />proposed structures on the lot • Show any proposed grading changes <br />• E,Itiling and proposed utilities • Show measurements <br />wA <br />DO NOT WRITE BELOW THIS LINE <br />O <br />PERMIT CONDITIONS <br />1. All calls for Inspection shall be made 24 his in advance - phone 259.8810 <br />tom\ <br />2. All work shell be pedo-mnd in accordance with this permit and current City at Everett Design and Construction <br />Standards and Specifications <br />3. Call Location Underground Service 48 firs before you dig TOLL FREE NUMBER 1-800-424.5555. <br />z <br />4. Install rock construction entrance behind driveway as per city <br />standard N20B to reduce tracking mud onto streets and a-osion <br />O <br />control as directed by Public Works Inspector. <br />5. Keep city streets clean at all times. <br />L <br />6. Curb, gutter and sidewalk in the plat are new and undamaged, <br />r <br />any damage thereto shall be replaced at the discretion of the <br />�/♦ <br />Public Works Inspector. <br />7. Any change in the driveway cut must be approved by the <br />O <br />Public Works inspector. <br />B. Tightline all roof, yard and driveway drains from houses to storm <br />A <br />Iris <br />drain stubs at back, of side walk with rubber gasket P.V.C. pipe. <br />L <br />9. Adjust water boxes to grade at end of construction. <br />10. Driveways shall be completely cured before driving on them. <br />II n ACKNOWLEDGEMENT OF CONDITIONS <br />�ctust �1� 2-ZCp-Di <br />Approved for Constr ,Ibn —7 Date <br />FINAL IN80E ION Date <br />Approved as Constructed <br />r�rmn PUBLIC WORKS DEPARTMENT <br />Ever tt,WACedaStreet <br />Everett, WA 90201 <br />Phone! 259.0810 <br />The undersigned owneNBpplicanl hereoy agrees to hold and save harm- <br />less The City of Everett from any end all claims for damages. costs. <br />expenses, or causes at action that may arise because of installation <br />and maintenance of the improvement or other righl-of-way use hereto <br />applied for and further agrees to remove same upon notice from the <br />City and to replace public property damaged thereby. <br />%VRK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO I <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIF <br />PROJECT OVER 90 DAYS DURATION. <br />