|
���
<br />�o�x
<br />G H
<br />�Hxtn
<br />yxH
<br />�H�
<br />'� H '31
<br />fA H�+
<br />�OM
<br />y
<br />��8
<br />n� �
<br />t"yZ.
<br />HH
<br />ti
<br />C'1 �y Ul
<br />M
<br />HO�
<br />�
<br />� ��
<br />��
<br />�w�w�
<br />� /
<br />1 . � l.
<br />�,ie '�� �, �� � ' , ,r
<br />, �,��� ,��,,, � ,,
<br />PUBLIC WORKS PERMIT
<br />Pnnl or Type Only
<br />. .. . i.� ��� � �
<br />,,, . q�, /z � v� �
<br />,
<br />: ,:.,..,,. s --- --
<br />,., �... �,..�, s
<br />� o._„ .. u ., _a � _ _ .
<br />��1��c�c� w� � _�1� , i � 9 �a��� .; - -
<br />� C 1_- ��--_�f[C� �c:�c �,� � n r✓ /-
<br />Ownri
<br />ra.����,��� ,� ;n�.�,•. �nv Lv i�i�.,�- ,
<br />�fLLNA- - - __ --- - --
<br />— -- -
<br />Apphcani tde�linu n,�.i���.,., Giv LP on '
<br />Dr,cnbc PioPosrd Waw ___N �.LSL�I�1��-�- . ��N i �t� /1`� - -. �-i�� `�.. �'1 LflS �. L!`ii1..L_ :: .� ..
<br />p�oier,l AAAiusslil knownl ---�2'.� � JU1 'SL ✓\V __ _ . __ _ .. . .
<br />Atld�'h lom �di conies ol plan� lo� P�oposed woiA � Draw to sralr nnd n. Ie Ihe IoPowm9 as apP���able�
<br />• Prupeity Lmes • ('onlrrlmc ol slrecl
<br />• Ouibno lnd Aim��nsions ol ull Pt�s�inq :md • Indira�q NorR•,
<br />proPnsi��l sVm linrs nn �I-�r In� • Slinw nny P�n��.�v,�l W adin�� rlianq�.•,
<br />• F n.,bnq dntl {^npu.��d uLhln.t • Shrw ir.�.i.0 .�.� ..,
<br />I ��
<br />�,
<br />ylLr
<br />PEf7L1ITCONDIT10N5 �
<br />I All caP.s lor �nsprc�i0n c,h:ill be mnde 24 his m advance � p����nr Q�'jg'$$� �
<br />2 All work Shnll l�e peAormptl in Bccordance wdh �his U�rnul and cinrrnl G�Iv rd 1 vmott Ilrsun anJ Consliucl�on
<br />SlandarAs anA Speuhcalions.
<br />:i Call LocaUon UnAer�rounC Service 4d hrs bebre you diy TOLL FREE NJMBER 1•800•424•5555.
<br />4. Install rocY �onstruction ent.rance behind driveway as per rity
<br />standard 5208 to reduce tracY.;nq miid onto �treets avid erosion
<br />�ontrol as directed hy Fublic Works Inspector.
<br />.. Keep rity streets r_lean at all times.
<br />h. C�irb, y��tter and sidewalV. in the plat are new and undamaqed.
<br />any damage thereto shall be reple.ced at the disrre�ion oi tt��e
<br />Public Works inspector.
<br />�. Any chan9e in lhe driveway cut must be approved by tl�e
<br />P��bli� WnrAs inspe�tor.
<br />8. Ti.yhtline �11 rooi, yard and driveway drairs from hous��=. to s.tu
<br />drain stubs at bacY, of •;ide wa1V, with rubber gasl:et P.V.C. n�i��-�
<br />9. Adfust water boxes to grade at end of constniction.
<br />1��. Driveways shall be completely cured before drivinq on them.
<br />` c �,.�. Cv� ` iCas�, _ _ �-_L� - 91_
<br />n��n,n. .�; I„� . .�n�d�u/c�hcn Dnte
<br />�1..�-I��� /O -/�-'�/ .
<br />I iNnL :NSPf('.tION Date
<br />Appruv� A ac f.��nsliucied
<br />„�,•❑ PUOLIC WORNS UEPARTIdEIlT
<br />1 3200 CeAar St�eel
<br />r�� �u wn�a2oi
<br />�� 1'n � . : 59 NetU
<br />W
<br />�
<br />�
<br />�
<br />Z
<br />O
<br />�
<br />Y /
<br />O
<br />a
<br />PCKNOWLEDG[MHNT CP CONDIU� '
<br />The undnrsigned owner/appbcant heraUyagreesto i� '
<br />less ihu City ol Everrlt Irom any nnd all claims I:�� �, ,. ,... '
<br />rvpensus. ol cTu5e5 Of acLon Ihat mly nnsn beCa�c.•! ut ins'.�� '
<br />and maiN�,nanr.n ol P+r �mpmvnment o� olhcr u9hP�il�waY us�. �. .
<br />uppl�Ptl Ini nn�l twln,•i dqmrs �o irmoVC 9nme upOn nUhf.e hun� In .
<br />GtY anil In �rP�.n��• put,�i� pr„p�.,ty il:�ma9r.d Ihereby
<br />rl /
<br />� �.c� � �' 4� U,'` `..�.i -----
<br />$iqnn wc nl APphrdnl D�e�v
<br />�ypR PUIHOR17[D H�' llllti PI HMif MUST fiE SIARTFO WIiHIN
<br />0 oavs or on1[ P�r�rnir i ��ui_n nNn n�[aenrta� �, i��
<br />[lY�ILIG@NILY PUf75UL.D TO c� r.I'I I tlrir. �1 .; I'1 HHIt !�,»' R!
<br />f,�NCC�I.CD(1Y111LCI1'VUP�14 . '-i�ii'�Y I �IIY�n� �Nllllb
<br />1'Hf IJ� f'i �-'i9 R+D IIA� 51)lll.A I.�
<br />
|