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Late_'31lifkr, <br />pPpl. il,. n, I['., <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />P.rbl¢ Permo • <br />Bldg Door <br />ol . • 86 16162 <br />Public Wore, Fee <br />Total Fee <br />Lest Appl Fee Peid <br />Balance Due 4 <br />Boyden Realty, Inc. 1429 Broadway Everett 98201 252-1166 <br />Ownhr Mailing Address City ZIJ Phone <br />J 6 D Builders 142, Broadway Everett 98201 252-1166 <br />Applicant Mailing Address City Zip Phone <br />Describe Proposed Work New Single Family Residence <br />Project Address (if known) <br />204 - 93rd St., S.E., Everett <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the following as applicable' <br />• Property Lines • Centerline of street <br />• Outline and dimensions of all existing and • Indicate North <br />proposed structures on the lot • Show any proposed grading changes <br />• Existing and proposed utilities • Show measurements <br />UO NOT WHITE BELOW THIS LINE <br />PERMIT CONDITIONS <br />1 All calls for Inspection shell be made 24 hrs. In advance - phone 259.8815. <br />2. All work shall be performed In accordance with this permit and current City of Everett Design and Construction <br />Standards and Specifications <br />3. Call Location Underground Service 43 hrs. before you dig. TOLL FREE NUMBER 1.800.424.5555. <br />4. ANY GRADI�, DONE ON THIS LOT SHALL BE DONE SO AS NOT TO IMPACT THE <br />SURROUNDING LOTS WITH RAINWATER RUNOFF. <br />5. DOWNSPOUTS FROM THE BUILDING ARE TO BE TIGHT -LINED TO THE PUBLIC <br />DRAINAGE SYSTEM. <br />6. ANY CURB 6 GUTTER DAMAGED DURING CONSTRUCTION SHALL BE REPLACED BY THE <br />APPLICANT. <br />i <br />PUBLIC WORKS DEPARTMENT <br />EverCeder Street <br />Everett. WA 98201 <br />Phone: 259-8815 <br />W <br />ttw <br />Cn <br />W <br />0 <br />Z <br />0 <br />rrry <br />V/ <br />O <br />a <br />ACKNOWLEDGEMENT Of- CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the City of Everett from any and all claims for damages, costs. <br />exi ruses, or causes of action that may arise because of installation <br />and maintenance of the improvement or other right-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 />Signature of Applicant D to <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION, THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DJRATION. <br />