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� � <br /> o �x . � <br /> t"�HC V1 <br /> HZ� <br /> K y r�nj Date 10/10/91 . .. ' . � � r,�n,�wo,..r.,mn. _._. <br /> oQ 91/27923 <br /> �tl N htl APPIica�ion�FOf n..�q �eoi • _. <br /> ��� PUBLIC WORKS PERMIT ���^,°<w°,�,°°. <br /> ra�.��., s <br /> �r,..00� F,e P.,a s <br /> o�g(� � Print or Type Only a•r��P n„o s <br /> �Y n <br /> �., y� Eugene A. Wlggins 1809 Vailey Ave Everett 98203 355-7881 <br /> F"� H pwner Mailing AOtlress City Zip Phone <br /> gy <br /> � <br /> ��y _ <br /> � �ftl[I[X For Owner bv R. Scott Turne: <br /> y Appllcant MaiGng Address Cily Zip Phone <br /> O(n <br /> Descr�be aroposed Work �Zsf Bedroom expansion <br /> - W IProlect Atldress lil knownl 1809 Bailey Ave. � <br /> Attach lour�4)co0�as ol plans lor proposed wo�k� Draw to scale and nole Iha lollowing as applreable. �� <br /> • Property lines • Centerhna ol street ♦A <br /> • Oulline and dimensions o�all e��sting antl • Intlicate North V� <br /> proposed slruc�ures on I�e lot • S�ow nny proposed gradiny ch,nges <br /> • Ezisting and proposr.d ulilities • Snow measuremenls Y <br /> iir <br /> DO NOT WRITE BELOW TNIS LINE <br /> ' ' PERMIT CONDITIONS O <br /> 1.All calls for inspection ahall be metle 24 hrs.in advanc��phone 259•8810. � <br /> '�I 2.All work shell be perto�med in ac[ortlance wilh�hls permlt and cunent City ol Evemtl�esign and Construction <br /> Stentla�ds enA Specitications. <br /> '�1 3.Caq l ocalion Unde�ground Service 48 hrs.belare you tlig.TOLL FREE NUMBER 1•800•424•5555. � <br /> 1_I �\ O <br /> '—' / (���t- �l/t.�.� �vl.,.,.a:{�l/O-T`' ��i-Cl.t:•.-✓' <br /> �,� /o �/y-9i � <br /> I-1 � � <br /> �_I 0 ' <br /> _� a � <br /> _�_ <br /> � ACKNOWLEDGEMENT Of CONDI710N5 j <br /> f' _ The undersipneJ owne�/opplicanl horeby agrees to hold and save ha�m� <br /> � less Ihe City of Evnrell liom any and all cla�ms lor tlamages, cosls <br /> eepenses. or causes 01 act�on ihat mny anse because ol m5lallahon <br /> and maintrananco ol Ihe improvemenl or olher nght-o4way use herelo <br /> npplied lor xnA �urlher a�7rees �o remove snme upon nolice irom �he <br /> Apnrovetl lor Conshuction Dale City and to replace public piopenY damagetl thereby. <br /> fINAI INSPECiION Date — <br /> ��pn�uveA as Constructed Si9�alure ol ApP��Canl Date <br /> �_` ' PUBLIC WORKS DEPARTMENT WORK AUTHORIZED JV THIS PERMIT A1UST BE STARTED WITHIN <br /> � 3200CetlarSiree� 100 OAVS OF DATE PERMIT IS ISSUED AND THEREAFTER IS i0 <br /> Everet[WA 98201 BE DILIGENTLV PURSUED TO COMPLE710N THIS PEFMIT MAY BE <br /> Phone'.259�BB10 CANCELLED BV THE CITY UPON ANV STO' PAGE OF WORK ON THIS <br /> PFOJFCT OVCR f!0 DAVS DURATION � <br />