Laserfiche WebLink
Dale_ LI 13�'i I "' <br />I / <br />r�i Appllcation Fur <br />�'J <br />PUr3L�C WORKS <br />O <br />r� <br />Prinl or Type Only � � `Q'. � ": � <br />-u t� �n o � o <br />4� � y� P W � <br />O� u� <br />���-�-�- ' <br />ner � r� c Mai y�0 <br />.�+ g `'� m � u°�5 <br />�l�N4 � �33a �m�ro <br />Apphcanl <br />PEFMIT <br />p rj O lli <br />0 o.n�� <br />ti W �O.Y <br />M W .-+ <br />.-+ N— <br />�Q-�.�- o, �-�a <br />`r-if''���w <br />�a �� <br />Mailm9 AAA:ess <br />CdY Zip <br />^ub, �. Nro�� Vnrma . ✓ L/' ��%'"�I_"_ _ _ <br />d�,., nrni . ��_{y_7_�I_' __ <br />� �,,,�,,: ,v�,,, � �� <br />,�,.,� ��� s _— <br />l.v�nni rr�•v..�n S <br />Aoin�rr Oii. S. Z�'7 J <br />/�� ,,��� 1 /'''��' ,,,/// / ,,, � <br />D����r.riUc Proposed Wo�k � J�'�'I1�11L.��J1_��.�/�L�/L�— �—+���i��QJ�_ <br />f io�cr.l Address lil known) — �� � S{' h '�'t' S�� <br />qttach lour �a) copies of plans lor proposed work � Draw to scale nnd nole thF lollowmg as applicalde <br />O Properry Lines • Crntcrline �i slreet <br />• Outline and dimensions ol all esisting and • Indica�e Norih <br />proPosed struc�ures on Ihc lol • Show any ProP��scA 9rad ng r,h:inycs <br />• Exlslin9 and proposed util�ties • Show measuremenis <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be matle 24 hrs. m advance � phone 25g•8810. <br />2. All worh shell be perlormed in accordance with Ihis permil and wnenl City ol Evaelt Desiqn and Construction <br />Standards and Specilicatlons. <br />3. Call Location Underground Servire 48 hrs. beiore you dig. TOLL FREE NUMBER 1•800•424•5555. <br />4. <br />6. <br />7. <br />8. <br />9. <br />ln• <br />Install rock construction entrance behind driveway as per city <br />standard N209 to reduce trackinq mud onto streets and erosion <br />control as directed by Public Works Inspector. <br />Keep city street� clean at all times. <br />Curb, gutter and sidewelk in the plat are new and undamaged, <br />any damage thereto shall be replaced at lhe discretion of the <br />Fublic Works Inspector. <br />Any change in the drivewaY cut must be approved by the <br />Public Works In,pector. <br />Tiqhtline all roof, Yard and driveway drains from houses to stor <br />drain stubs at back of s.ide walk with rut�ber gasket P.�.C. pipe. <br />Ad�ust water boxes to grad� at end of construction. <br />Driveways shall be completely cured before drivinq on them. <br />` � - <br />��<«� �1- �_��,� �- `--� <br />APNaved lor Construcl � ��tF <br />�/ V /C/G!� �) �l `�/ <br />PINAL INSPECiION ���� <br />Anp�oved as Constructed <br />���i•��q� VUBLIC WORKS DEPARTIdENT <br />� �200 Cedar Streol <br />Ccmclt. WA 4820� <br />Phonr 25&Fl810 <br />� <br />� <br />� <br />Y / <br />O <br />a <br />�CKNOWLEDGCM[NT OF CONDITIONS <br />The und�:isq�ncA owncUapphr.anl hereby ay�ees �o hold antl save harm� <br />less Oic City ul Eve�e�l Irom any and all daims lor damac�es. costs. <br />ozpense:. or causes o� action Oial ciay anse because ol installa�ion <br />anA rnantenance al the imp�rnement or other nghbol�way usi� here�o <br />appheA lor and Iwlhei a�rces lo remove same upun nohcc Irom Ihe <br />Gty ���d lo rePlace pubLc P�cl�ri��r d;im;iqeq Iherehy <br />.aa.��� —�.___—_ -� _.. <br />Sic�nnlure of hpphcanl —���9��Ic <br />WORK �UTH6RIZED BY THIS P[RMIt �AUST OB SfARTFD WIIHIPI <br />1�0 DAVS OF DATE PERMIT IS ISSI� AND THEREAFTER IS 1(� <br />�L �!LIG[NTLV PUH"dUEG TOCOMPL' i)N fH15 PEFMIT MAV HC <br />C�NC�I t f f� [l I iHF CIT" UPON �NY tilUPf'AGI nf WORK ON I1115 <br />I'fi�l.11 CI i�A'i H �++) (U,YS [IURAI��)N <br />