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Date 8-24-93 T(� P�cTINf, 2-z8-g <br />Applicallon For <br />PUBLIC WORKS PERNIIT <br />Print or Type Only <br />PUEiic WorFe Parmil � � TI� / <br />ema Deo� • L 17R6 <br />Publ¢Wo�haFae s <br />Toial Fc� <br />Lav LpO� Fee Pa�C $ _f�}� <br />Balance �ue S � �� • � � <br />City of Everett (Chevron iISA) 3200 Cedar St Everett 98201 <br />Owner Mailing Addiess Cily 2ip Phone <br />Robert H Lee 6 Asec 1137 N McDowell Blvd Petaluma CA 94954 (707) 765-1660 Robert Picard <br />Applicant Mailing Address City Zip Phone <br />Descri6e Proposed Work aervice station remodel includinR canopies 6 sales bulldinR <br />� Project Address (if known) <br />Attach four (4) copies ot plans lor proposetl work • Draw to scale and note Ihe following as applicable: <br />• Property Lines <br />� Outline and dimensions of all existing and <br />proposed structures on the lot <br />� Ezisting and proposed utilities <br />• Centerline of street <br />• Indicale North <br />• Show any proposed grading changes <br />• Show measurements <br />PERMIT CONDITIONS <br />1. All calls for inspection shell be made 24 h�s. in advanca - phone 259•8810. <br />2. All work shall be performed in accordanca with this permit and current City of Everett Design and Consiruciion <br />Standards antl Specifications. <br />3. Call Location Underground Service 48 hra belore you dig. TOLL FREE NUMBER 1-800•424•F.Ci$5. <br />`I'� fFs �•"� aNP'-°✓c� Planf dabcd �z�zo�q3. <br />t'/,c�ti�i/�'1 �,G-� lZ/zr�/93 <br />Appr ved lor Constru tion Date <br />� �y�- <br />FINAL INSPECTION ' Date <br />Approved as Corslru��ed <br />����PUBLIC WORKS OEPARTMENT <br />3200 Cedar Sireel <br />Evere�t, WA 98201 <br />Phone:259•8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />H <br />7 / <br />• <br />� <br />� <br />� <br />a <br />The undersigned owner/applican� hereby agrees to hold and savo harm• <br />less the Cily ol Everett from any and all claims lor d: mages, costs, <br />expenses, or causes of action Ihat may arise because of installation <br />and maintenance of �he imprOvement or other righl�ol-way use here�o <br />applied for and lurther agre to remove same upon notice hom Ihe <br />City and to eplace public pr erl damaged thereby. <br />�ti- �z-�� <br />SI alure ol Ap icant Date <br />N'OFK 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 BC <br />CANC[LLED BY THE CITY UPON ANY STOPPAGE OF WURK ON THIS <br />PROJECT OVER 90 UAYS DURATION. <br />