Laserfiche WebLink
Date 12/18/91 <br />Application For <br />PUBLIC WOR:CS PERMIT <br />TO POSTING_ 3 ?- q -grf <br />Print or Type Only <br />(/ <br />PObI1C 1Yoeks Permit <br />Brdv Dept a 91/35127 <br />Publ¢ Works Fee $ -_- <br />Total Fee <br />Less Appi Fee Perd S � <br />Balance Due $ <br />OD? 372 W 000 <br />�Z - _ City Zip Phone <br />Mailing Address <br />Owner <br />1218 - 3rd Ave #30623-0331 <br />WJA 6 Seattle WA 9810y Zip Phone <br />Applicant Mailing Address <br />aariitiM <br />Describe Proposed Work <br />W <br />5416 S. 1st Ave. <br />Project Address (if known) — <br />Attach four (4) copies of plans for proposed work -Draw to scale and note the fallowing of applicable: <br />• Centerline of street <br />• Property Lines • Indicate North <br />• Outline and dimensions of all existing and • Show any proposed grading changes <br />proposed structures on the lot • Show measurements <br />• Existing and proposed utilities <br />DO NOT WRITE BELOW THIS LINE <br />O <br />PERMIT CONDITIONS <br />1. All calls for inspection she be made 24 hrs. in advance -phone 259.6810. <br />this permit and current City of Everett Design and Construction <br />2. All work shall be performed in accordance with <br />Standards and Specifications. <br />TOLL FREE NUMBER 1.8/00.424.5555. <br />3. Cell Location Underground Service48 hrs. before you dig. <br />Y. l��/� Jlit' �1CiS �insi !f idG(�rij/ Curb emu/ e4 hci Si4'Iu Lllk C1717� <br />O <br />- <br />, P�4f� Ire:, esif w6. <br />Z— G71- �� 4S s2 rn� T/7a rr7r �Cr% <br />N <br />J � o ✓l S bl/�Gtc)l � �" (�Ol t't� I vt \ Lo � EDN'0 A -I �e> <br />�taLS (D 5�a l l s All tj%/ <br />C lillrrP� <br />/p (,v>p �Pi 144 C\ d �l� eo AiKNOWLEDGEMENT OF C NDITAA <br />/ l The undersigned owner/applicant hereby agrees to hold and saES hosts <br />Approved for Const uchon <br />Date <br />Date <br />FINAL INSPECTION <br />Approved as Constructed <br />PUBLIC WORKS DEPARTMENT <br />3200 Ceder Street <br />Everett, WA 98201 <br />Phont:259.8810 <br />less the City of Everett from any and all claims for damag <br />expenses, or causes of action that may arise because of installation <br />and maintenance of the improvement or other right-ol-way use hereto <br />applied for and further agrees to remove same upon notice from the <br />City and to eplace public property damaged thereby. <br />z-s-9Z <br />Date <br />Sig lure of Applicant <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 DURATION. <br />