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Date 9-18-91 Public Wyk,PO,ml1• _ <br /> Application <br /> slap.0001.• 91/2773'_' <br /> PUBLIC WORKS PERMIT P°aTobi FPee00Kwr.. <br /> f <br /> Ln•w.pL ru PIA S <br /> Print or Type Only Bilone•p"• !{ <br /> ,TAMCO 1018 80th St SW Everett 98203 347-4735 <br /> Owner Mailing Address City Zip Phone <br /> Mulvanny/Lege 12200 Northrup Wav Vellevue 98006 881-7600 Paul Hannemann <br /> Applicant Mailing Address City Zip Phone <br /> Describe Proposed Work TI — 26,000 S <br /> LU <br /> Project Address(if known) 1122 80th St SW <br /> Attach 'our(4) copies of plans for proposed work- Draw to srale and note the following as applicable: <br /> • Properly 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 /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS O <br /> 1.All calls for Inspection shall be made 24 firs.in advance-phonu 259.8810. <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 48 firs.before you dig.TOLL FREE NUMBER 1.800.424.5555. <br /> N oT izdv-, real <br /> mcnc <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 /> expenses. 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 /> Approved for Construction Dale City and to replace public properly damaged thereby. <br /> FINAL INSPECTION Dale <br /> Approved as Constructed Signature of Applicant Date <br /> PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200 Cedar Street 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett WA 98201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone:259.8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />