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�' <br />TYPE OR PRINT ONLY <br />eooi�cauon For <br />PUBLIC WORKS PERMIT <br />PU�L1C WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, VUA98201 (425) 257•BB10 <br />Tp !'OSTING �R � R 2°°0 <br />Date _ 6-7-99 <br />Public Works Permit # ���— <br />Building Permit N �2677 _ <br />Public Works Fee $ � <br />Kvernmo Const 4309 Crescent Ave Everett 98203 425-259-0599 <br />Owner Mailing Address Ciry 2ip Phono <br />Owner <br />Applicant Mailing Addwss Ciry Zip Phonn r�, <br />Describe Proposed Work <br />new house - Basic 2010 <br />PROJEC7 AU�RESS (ii known) <br />Lot <br />Attach lour (4) copi�s plans tor proposod work - Di :w to sralo and noto the lollowing II �ppliCabio: <br />• Propeitv Lines • Oullino and dimensions ol all existing and proposed structures on tno lot • EKisting and propused utilities <br />• Cenlerline oi stroet • tndiwte NoM • Show eny proposod grading changos • Show moasuroments <br />DO NOT WRITE BELOW THIS LINE <br />PERIdIT Ci�NDITIONS: <br />1. All calls (or insp^ction �hall be made 24 hours in edvanc. - phone (425) 257-8810 <br />2. All work shall be peAormed in accordance with this permit and current City of Everett Design and <br />Consiruction Standards and Specifications. <br />3. Call Location Undergrourni Service 48 hrs. belore you dig. TOLL FREE NUMBER 1-800-424•5555. <br />�.� �-�.t1�Q rv�crF� k� y�1�5►� b(ar�k5 �,r �hark Pl�� w�z��O. <br />W <br />� <br />�� <br />V / <br />�j. T��,co� r'c�or�t }� J. KcJJ�Cvoss d2ttcd 5/4�98 S�z,�zs "�icc.a✓.� �oi' <br />5�ah 1is h?+s�"'�, Crhwl h�t�GS... w7�I �d-fv 6e uvI h�� -fv ,�-l�w� <br />w�tiX dur � n9 Caete �'k�{•d- �✓� �e.vti o c�s . Cm^ s�rv�� on o� �('+.e. l�wvleS sl�w I d <br />�,� �h.� po+.c,.�t��� -(+.- l,w-��.�Z su b9�d� ,....c�� a,�d cw���a� <br />S�qfaid�¢ drrd�hRg.C, V%+��OI' irl�+'f�G✓f� ctt. �'Dr'�i5 ff.zSOn Cl�w� s�acG��L <br />�A�S-irv�k °�'� Sha�ld it ol/o�dcd. <br />ACI(NOWLEDGEMENT Of C�;NDITIONS <br />The undersignocl ownerlapplicant hereby agroes to hold and save harmless <br />Iha Ciry ol Everetl irom any and ell clnims for damagos, costs, expenses, or <br />causos ol aclion that may arise bocause ol InslallaGon and mainlenance ol tho <br />improvement or other right-0f way usa hereto applied lor and lurther agrees to <br />remove ame upon noti e m the City end to replace public properry dam- <br />agod t roby. <br />� 4 ` <br />re o pp ican a <br />VJORK AUh10R�D BY THIS PEFU+9' MUST BE 5TAR�fED WRFIIN 1B0 DAYS OF DATE PERMR IS ISSUED ANO THERE�1FfER IS TO BE DIL1GENfLY PURSUED TO <br />COMpLET10N. THIS PEFiMR MNY BE CMICELLED BY THE CfTY UPON ANY STOPPAGE OF WORK OM T1-�IS PROJECf OVER 90 DAYS W RAT10N. <br />