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� <br />TYPE OR PFINT ONLY <br />qpplication For <br />PUBLIC WORK� PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Sireet <br />Everett, WA 98201 259-8810 <br />AUO 0 4 1991 <br />jp POSTING <br />Datq_ 10/3/96 - <br />Publlc Works Pertnit N � — <br />Building Permit 8_� 41 i n — <br />Public Works Fee $ <br />�� <br />GAGNAT CARL & DONNp 661 �i�Y Zip Phone <br />Ownor Mailing Address <br />Describe Proposed Work <br />PROJECTADDRESS(ifknown) 6613 �tr��� nuuwo«o <br />g hcable: ELDG 51112.85 <br />Atlach tour (4) copies ot plans lor proposed work - Draw to scale and notc �he f�ilowin If epp' . d utili11�89.00 <br />■prop¢rty lines 'Outline and dimensions of all existing and proposed structures on the Int Existing and prB�e 5120.00 <br />•Centedine of streel •Indicate Nodh 'Show any proposed grading changes •Show measuremenis MECH <br />DO NOT WRI1 E BELOW THIS LINE �� �0867 4 0.00 <br />PERMIT CONDITIONS: �W�c 470.00 <br />1. All calls for inspection shall be made 24 hours in advance - phone 259-88'0• �v� ��g�� <br />2. All work shalf be performed in accordance with this permit and current Ci of �,�` � szk02.:{5 <br />Construction Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800 424-5555• <br />Inslall nn intiltralirni trrnch hu�lt �s p�r Ih<• cih�'� .:Residetdial R.00f1)o���i::p�id SVS�PiTI � fI^R�.iil <br />sized tu; per tlie cily's Tablr Ill-3.2 "Roof llownspo�d Syet�m Sizing' ,isy�led �o ILi; penwc "IL <br />iidillr.diou heuch :.h:ill Le �io clo,er W.m 5 fecl to .wy up slope prop�•��' liur or fowid<ilion nor c <br />ihtm l0 teet to :ui}' do�ti'u�lopc prnprrt}' line or foundsiliou. Call Public \Vor1:s for :ui inspcctiou <br />�o cm'rrinc �rencl:os <br />/.1Q`' ACKKOWLEDGEMENT OF CONDITIONS <br />r <br />Th� undersigned owner/applicant horeby agrees to hold nnd save hertn ess <br />�O � the City ot Everetl trom eny and all claims for damages, costs, expensas, or <br />causes of action that may ans3 because of Installation and maintenance ot <br />Appr edfor lon � Dat �helmprovementorothernght-of-wayuseheretoappliedforand�urtheragrees <br />/� to remove same upon notice Irom tha Ciry nnd to replace public property <br />, . �- .Z / " � , damaged Ihereby. <br />;!i <br />FINALI SPECTION Date � ) IO/�i (�G <br />qpproved as Corstructed !/� ate <br />Signature of Applicant <br />COh1pLETION. TIHES PERMIT MAY BE ANCEB ED BYTHE CINIUPON ANY S�TO PAGE OF WOFK ON THIS PRGJEC OVER 90 D� S DUL�T�ON`Y PUf±SUED TO <br />