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T^ POSTING M-Ar__._! d " <br />Appllcetbll For <br />PUBLIC WORKS PERMIT Date ----3--'8-/9J'----- /�/ <br />BI IC WORKS DEPFJiTMENT Public Works Permit <br />3200 Cedar Store! <br />,-it, WA 98201 259-8E10 <br />Buuding Permit N 54661 <br />R8828 8 Fig SR <br />TYPE OR PRINT ONLY 9r. (((p��nl.. Public, works Fee S -�_ ._._. <br />Roreeth Custom Home 1241 Sta A Av M9Tys�lle 'i817J G53—J720 <br />--- — <br />Owner Mail s � C QQ.�-r Zipp <br />Phone <br />..� _ , <br />Owner y� <br />Applicant Mall 1IT � Address City Zip Phone <br />Describe Proposed Work new house <br />PROJECT ADDRESS (if known) <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the following If applicable. <br />•Property Lines 'Outlino and dimensions of all existing and proposed structures on the lot •Existing and proposed utilities <br />•Centerline of street •Indicate North •Show any proposed grading changes 'Show measurements <br />PERMIT CONDITIONS: <br />1. All calls for inspection shall be made 24 hours in advance - phone 259-8810. <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and <br />Construction Standards and Specifications. <br />3. Call Location Underground Service 48 hire, before you dig. TOLL FREE NUMBER 1-OW-424-5555. <br />1 Keep city streets clean at all limes. <br />5. Club glitter and aidrwalk hr the plat are new and tuudarnaged, any darndge thereto shatl b: replaced at <br />discretion of the public Works Inspector. <br />6 Adiust water boxes to grade at end of construction. <br />1. Driveways shall be completely cured before driving on than. <br />8 Rooftop drainage shall be discharged to a system approved by the public works department - the final <br />Inspection for this house will be perforrncd only after the system has been installed rnd approved by the <br />city. <br />FINAL INSPECTION Date <br />Approved as Constructed <br />W <br />F- <br />co <br />O <br />z <br />O <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harmless <br />the City of Everett from any and all cialms for damages, costs, expenses, or <br />causes of action the' ,nay arise because of Installation and maintenance of <br />the improvement or other right-of-way use hereto applied for and fu'ther agrees <br />to remove same upon notice from the City and to replace public property <br />damaged thereby <br />2 61 _ <br />Signature of Applicant Date <br />WORK AUTHORIZED BY THIS PEP.'.IR MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO <br />COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURAi ION. <br />