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��� ,: <br /> � y� , � . - <br /> B/2/91 r�eec wo,..v.,mn. <br /> � �� V219 niau o�ni . 91/174'6 —_. <br /> MMy � ppplicalion Fur <br /> M� <br /> � �� PUBLIC WORKS PERMIT PuoTot�fee��� _ <br /> lee�eDn��eePna S <br /> y <br /> �x Oelancvoun S <br /> Qy b Print or Type nnly <br /> O 1-i <br /> O <br /> p�c� G E Baker Const. Znc. 4734 Bayview In Everett 98203 347-0870 <br /> �-I C Mailing Adtlress City ZiP Phono <br /> Z y 3 Owner <br /> C Z <br /> �~ y Z�p Phone <br /> �N� ��� pplicaN Maihn9 Address ���Y <br /> ��"j Addition to SFR <br /> Dnscribe Proposad Work <br /> O V� — <br /> W <br /> Projer,l Address lil knownl 4734 Ba 1eW Ln � <br /> �e <br /> pllach lour 141 coGies ol plans lor Proposed work� Draw lo scaln antl note�he lollowing ns aPP�icable' � <br /> • property Lines • Centorline o�street <br /> • Outline nnd dimenslons ol all existinq and • Indicale North <br /> proPosed struclures on the I �i • Show any proposetl graAinq chan9es <br /> • Erisling and proposed utilitie, • Show measuroments M <br /> W <br /> DO NO7 Wq�TE BEI.OW THIS LINF_ O <br /> \ PERMIT CONDITIONS <br /> (��" 1.All calls lor inspection shall ba made 24 hrs in�dvanco�phone 259�8810. <br /> 2.All work shall bo pedormed in accordance wilh ihis penn'd ard curreN City ol[verett Design antl Construclio❑ _' <br /> � � Standnrds and Specilications. � <br /> � � 3.Cell Loca�ion Underground Se.rvice 48 hrs.6elore you tli� TOLI FREE NUMBER 1•S00•424•5555. <br /> � � ' � <br /> � � <br /> � <br /> i �-� '(�l o �� �,1>,'c. l�lc�r I� '��,.ti� � k�� � <br /> + ��. �-1��r� Ca <br /> _,_ a-4� -�� a <br /> � , - <br /> ���� ACKNOWLEUGCMFNT O�COM17ITIONS <br /> I ____"__—__---___._._— _ _ _. . . . ._ llir undr.u,iqneA nwner/aPPl�cant heieUy a9iees lo hold anA savc hanm <br /> � Icss thc QIY ol Everelt hom any anA �II claims lor dam:�.i�,s. co,ls. <br /> '�1—� e.oenses. or causes ol aclion Ihat may anse because o� inslallabon <br /> and mamlenance ol Ihe improve!ment or olher n9hPol�way us�� herrin <br /> _ __. __ applietl loi and lurlher a9�ees to remove same upon notice �wm thc <br /> Appruved for C� nstrucbon����'�' f���t'. CtlY and to rePlace Public VroperlY dama9eA thmrhy <br /> FINAL INSPLCTION Date — —� �� Dale <br /> Approved as Consiru[led <br /> SiqnaWre o�Applicani <br /> � / WORK AUTHONIZ[D B� THIS PERMIi MUST �E STARTED WIiHI <br /> _� PUBLICWORKSDEPARTIdENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEFEAFTEH IS TO <br /> ��' 3200Cetl�uSireet �[ DILIGENT�Y PURSUED f0 COMPL[TION THIS PERMR MAY BC <br /> A��EFR Eyprait WA 98201 CANCELL[D 8V THE C�1�' l4'O�� �NV STOP['A�E nF WOPK ON TI11S <br /> Pho�r 259-8810 PROJECT nVFH 9�� U���S DUR4lIC,N <br />