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Y'`' POSTINr nuc o a�9a� <br />`eY���� . AP�IicationFor _.__. —__ _.___—_— .. <br />PUBLIC WORKS PERMIT °�'Q 9�25-'.'6 <br />� P�" cf(v/31c7 <br />IIC WORKS DEPARfMENT Public Works Permit ._. <br />3200 Cedu Sireet <br />Ev�tt. WA 9P201 259-8810 Bulidinp Permit N__ 53005_ <br />TlPE OR PRINT ONLY <br />Borseth <br />Owner <br />I �� ff`.', P i L i f� <br />� °�:,��"�� <br />. � <br />Const.ruction �241 StatP <br />Todd Borset'h <br />Anplicant <br />Describe Proposed�Nork <br />new house <br />r: =t <br />;� � <br />.r,i - <br />.�I I�I i� !r <br />i3 i,:l. G,. �' r� �. <br />Public Works Fee $ h� ~ <br />�„ , .,�-� — ---- - <br />�, � o � � <br />M ~ �-'i p� CJ <br />e +ssr3'E;viMe 9827U 359-1034 <br />',' Gity. > ; Zip --- Phone . <br />;. i ,- <br />�` � ,- <br />�; �+ � � , .1 <br />City <br />PFOJECT ADDRESS (if known) 108 93rd St SE Lot 20 Mt View Village _ <br />Attuh lour (4) copies ui pinns lor prnposed work - Draw to scele and note thr fol!owmg il eppliceble: <br />•Property Lines 'Qutline and dimenslons ol all existing and proposed slrucWres on the lot •Exis�ing and proposed utilities <br />•Centedine ol slreet •Indiceta Norih •Show e�iy p�oposed grading changes •Show measuremems <br />PERMIT CONDITIONS: <br />1. F,II calls for inspection shall be made ?4 hours in advance - phone 259-BB10 <br />2. All work shall be pe�lormed in accordance �, ith this permit and curre�t City oi Everett Design .ind <br />�onslructioc Standards and Specifications. <br />3. Call Location Underground Service 48 his, beforo you dic�. TOLL FREE NUMBER 1-800-424-5555. <br />1 F r^p al�: shccl� dran ,d :ill iimr:� <br />S. � mb p�uu�r ,md sidcwalk �u Ihc pl,u aic nra au;l midawat•, d. au� <br />discreiimi ol Ihr Pubiie Wmks Inspcclor <br />6. Adjusl wsdcf boxts lo p7adc al cud of consUucliuu <br />1)iivcways shall bc complelcly cured brfote d�i�iirv ..n �h ni <br />r< I;nolTop draina�c shall bc dischvr�d: <br />i,�i. I-12 to an appiu��ed inlillralion h�ncL <br />I r,l- 17 ?I in th' -tnirn �h;una��r tnh �nr���d �I �I Ili ���n r,l <br />pPro��j r ic o�i ' ^ L a e} �� <br />t <br />3.���(/ � _ � _ _—j� �` s% <br />FINAL n:SPECTION Da�e <br />ApproveA ;.s Constructed <br />d,nn;n•� ih: i:10 ,Irill b, icpla�cd ;d <br />� <br />W <br />H <br />a <br />Y� <br />� <br />A <br />� <br />� <br />� <br />♦i^ <br />Y/ <br />O <br />a <br />ACKNOWLFDG[M[NT OF CONDITIONS <br />The undmsgned ownedapplicnnt hereby �prees lo holJ antl s; .a harmless <br />Ihe ly of Everett 1rom y and . II dnims lor damages, costs, eKpenses. o� <br />ceu ss f action that m anse because of Instelletion end mnintenence ol <br />ihe pr ve I orP ther i hb w y1use herato applied for and further agrees <br />to mov � uj� e�ib�iqe City and to repl�ce public praperty <br />�\ <br />� <br />N'ORK AUTHOPIZFD JY THIS PERMIT MUST �E 517,RiED WITHIN 1P0 CAVS OP D�T[ PFRMIT IS ISSU[D ANOMiEflEAFTER IS TO BE DILIGENTLY PURSUE� TO <br />COMPLEiIJN iH15 P[RMIT MAY F7E CANC[LLCD OV iHC GITv UPON AN� STOPPAG[ Of �NORK ON THI ; PROJECT OVER 90 DAYS �URAiION <br />