26 81ST ST SW 2018-01-02 MF Import

Date. 10 21 y3 -T-0 _z5--1 Application For PUBLIC WORKS PA Print or Type Onl Public WPn4s Pllmll e pica DW a 42436 _ Public Worea Feb s Totel Fee Lees eDPI Fee Pe,d s i aebnce Due >< Alfred Jubie 1.821 19th Dr Mukilteo 98275 290-1456 ( ner Mailing Address City Zip Phone Owner _ Applicant Mailing Address Cily Zip Phone New house - Basic 227 Describe Proposed Work — -- Profec: Address (if known) - S� '�-•�- '`SW Lot 6 SP 35-90 Attach four (4) copies of plans for proposed work • Draw to scale and note the following as applicable, • Property Lines • Centerline of street • Outline and dimensions of ail 3xisling and * Indicate North •Show any proposed grading changes proposed structures on the lot • Existing and proposed utilities • Show measurements PERMIT CONDITIONS 1. All calls for inspection shall be made 2� hrs. In advance •phone 259.8810. 2. All work shell be performed in accordance with this permit and current City of Everett Design and Construction Standards and Specifications. 3. Call Location Underground Service 48 his. before you deg. TOLL FREE NUMBER 1.800.424.5555. 4. Install. rock construction entrance behind driveway as per city standard 020E and erosion control as directed by Public Works Inspector. 5. Keep city streets clean at all times 6. Curb gutter and sidewalk in the plat any damage thereto shall be replaced Public Works Inspector. 7. Any change in the driveway cut must spect.or, width at prop line limited S. Connect all roof, yard and driveway system provided to lot. are new and undamaged. at the discretion of the be a proved by the PW In- to a fisting apron width. drain to storm drain 9. Adjust water boxes to grade at end of construction. 10. Driveways shall be completely cured before driving on them. ApprovedforConstruction _ Date FINAL INSPECTION Date Approved as Constructed PUBLIC WORKS DEPARTMENT 3200 Ceder Street Everett, WA 98201 Phone:259-8810 ACKNOWLEDGEMENT OF CONDITIONS ca 0 n z 0 Cl) 0 a The undersigned owner/applicant hereby agrees to hold and save harm less the City of Everett from any and all claims for damages, costs. expenses, or causes of action that may arise because of installation and maintenance of the improvement or other right-ol-way use hereto applied for and further agrees to remove same upon notice from the City and to r�place public pro DMV damaged thereby. ^ Signature n Appilcam WORK RMIT MUST E STARTED B0 DAY OFF DATED PERMIT IBY THIq 5E BWITHIN ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION.