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�r� <br />h <br />ay <br />,ozx <br />9HxV� <br />y 5H <br />� H� <br />oxo <br />'�J H "�J <br />VJ H <br />yx rg <br />C7 O t�J <br />H t7 <br />OH <br />'�1 C) t7 <br />4� � Cq� <br />'�'HC7 <br />�yz <br />�yHH <br />ON <br />H <br />C] C7 f� <br />��� <br />Z H V� <br />H O [/� <br />Date 8-5-92 <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />PiAI¢ Y:o�F. Feimlt + <br />em� oeoi. • �.Z@�9 <br />PubLc WotNS fBC <br />Tolnl Fea S <br />Less/OPLFooPYid $ <br />o,m�« o�� s <br />Brian Olson 6928 Gvergreenlday Everett 98203 353-4533 <br />Owner Mailing Address City Zip Phone <br />Gregg Orte£a 347-1733 Snortv's <br />Apphcant Mailin9 Address City Zip Phone <br />Des�ribe Proposed Work CommeiCial addltioR <br />Projecf Address (il known) <br />Atlach lour (4) copies of plans br pwposed work - Diaw lo scale and note ihe lollowing as applicable: <br />• Property Lines <br />e Outiine and dimensions of all exisling and <br />proposed structures on ihe lot <br />• Existing and proposed utilities <br />• Centerline ol sireet <br />• Indicate North <br />! Show any �roposed grading changes <br />• Show measurements <br />IGII.9 <br />PERMIT CONDITIONS <br />7. All calls fo� inspection shall he made 24 hrs. in advance- phone 259•8810. <br />.m � 2. All work shall be pedormed in accordance v�ilh ihis permit and current City of Everett Desiqn and Consiruction <br />� f � Slandards and Specitications. <br />3. Call Location Underground Service 4B hrs. befon ;.,u �:, TOLL FREE NUMBER 1-800•424•5555. <br />��'� <br />M I <br />��• � <br />� � <br />��6�j <br />0` ;, I <br />m <br />� �� <br />PUBLIC WORKS PERA{IT <br />N T � <br />BY « <br />D AT � �a' � <br />i � <br />Approved for Cnnsiruction <br />FINAL INSPEG�ION Date <br />Approved as Consiructed <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Streot <br />Everetl, WA 90201 <br />Phone:259�8810 <br />ACKNOWLEDG[MENT OF (:ONDITIONS <br />.' <br />The unCersigned owner/apPlicant hereby agrees to hold and save harm- <br />less Ihe City ol Everett fwm any and all claimn for damages, costs, <br />ezUenses, or causes ol action that may arise bacause of installation <br />and maintenance of the improvement or olher righl-ohway use hereto <br />applied for and further agrees to remove same upon notice from the <br />City and to replace public properry damaged ihe�eby. <br />Signature of Applicant Date <br />WORK AUTHOR!ZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUEU TO COMPLETION. ThIS PERMIT MAY BE <br />C4NCELLEO BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />