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Date �f? "Zv -�� <br />nun��c;dian For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />�,�i,��� r.��,.���.,�„n. >� n93:_--- <br />��,�, ��,.�� . _� i zcoa�3 __.. <br />PuP�¢ AVolkf ifn <br />t�il,ll(np S <br />I rsv <on� Iee PmJ S <br />n..�.,�,:� o�P S LO <br />MATTSON �^�� g�0 ��GH A� M���ZYsv��LE, WA 9gz70 a5G-94iZ <br />Owner MaJiny Address Cily Zip Phone <br />—� APPlicanl Maihn9 AAdm<<- -�-- City�_--�- - Z�p Phone r <br />��M. <br />Drscrihe Proposed Woik _ ���SC l..�T_""1 _ _iZ� p�E__ L�N� <br />Proicct Address li� known) 3Z -�7 S'1{.i St <br />Altar,h lour 1�) r.opies n; plans loi propusr.A work � D�aw lo scale anA note Ihe lollowing .is applicable� <br />• Properry Lines • Center6ne ol sireel <br />• Outline and dimensions ol all eKistin9 and • InA�catr. Norih <br />proposed struc�ures on �he lo� • Show any proposed graAmg ch�n{��s <br />• Ex�sting and proposed ulilihes • Show mensuremen�s <br />PERMI? CONDITIONS <br />1. All calls lor inspection shall be maAe 24 hrs. in advance � phone 259•88i 0. <br />2. All work shall be peAormed in acco�dance wilh R�is permrt and current Cdy ol Everett Desiqn nnd GonsVuction <br />Standards and Specilicalions. <br />3. Call Localion Unde�ground Service 4B hrs. betore you dig TOLL FREE NUMBER 1•800•424•5555. <br />4. <br />5. <br />b. <br />7. <br />8. <br />9. <br />10. <br />V' <br />W <br />� <br />_ / <br />� <br />Install roc4 construction entrance behind driveway as per city /� <br />standard N208 to red�ice tracking mud onto streets and erosion �i� <br />control as directed by F'i�blic Works Inspector. <br />Keep city streets clean at all times. � <br />Curb, gutter and sidewalk in the plat are new and undamaged, <br />any damage theretu shall be replaced at the discretior of the '^ <br />Public Works Tnspector. ��� <br />Any change in the driveway cut must be approved hy the O <br />Public W�rks Inspert�r. � <br />Tightline all roof, yard and driveway drains from houses to storm <br />drain stubs at back of side walk with rubber gasket F.V.C. pipe. <br />Ad.iust water boxes to qrade at end of construction. <br />Driveways shall be completel,� cured before driving on them. <br />ACKNOWLEDGFMENT OF CONDITIONS <br />lh�� undersqlneA owne�/apphwn� hrieby a9rees lo hold and r�,avr hainr <br />less th�� GIY ol Everelt Irom any and all claims �or dam;Wi";. ��usls <br />�Kpe+nSes. or causes ol action thal may anse becainr. ol mstnllntion <br />� n 'r 1�� 2� zG � y � anA mainlenance ol Ihp mipiovemen: nr olher n9h��ol�way use here�o <br />A.LK. ;�ppLrd lOr and luithor a9ie�s to irmove same upon nolice irom the <br />Approvod lor Canstruc � n j ��Ie �itY ���d ta renl��e Pubhc proP�'�ty dama9ed Ihereby <br />�-/``�'" ��- -- 6_ 1" -•ri_ �'�- �� - <br />FINAL INSPECTION Date _ ---' <br />ApP�oved as Constructed Su aIu e ol Applicant Dalr <br />W( R AUTIIORIZ[D [3V THIS P[Nh11T MUST 8[ S7ART[D WITHIN <br />ew•rrll PUBLICWORKSDEPARTM[NT 100 DAVS OF DAi[ PI=RI.11T IS ISSUflD ANO THEREAFTEH IS TO <br />� 3200CederStroet 8[ DILIGENTLY PUHSU[D 10 COMPLLTION. THIS P[RMIT MAY 8E <br />EveretL WA 9E3201 CANC[LLFD �Y THF CITV UPON ANV STOPPAGG OF WORK ON THIS <br />Phone' 259-BB10 I'N(1.11 CT OVf P q(1 [IAY:i (IURATION <br />