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Applicaiion For <br />PUBLIC WORKS PERMIT <br />PUB�IC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 259�8810 <br />Date 3-25-97 -- <br />Public N/arks Permit tt _�a�-- <br />Building Permit s 54616 <br />/�c (� AUO 0 4 1991 7 <br />IVPEORPRINTONLY '�'' �l1,)TI�U- — Publ:cWorksFee$ C�%� <br />Paul Buatard 1373 S John St Camano Is 98292 65I-2172 _ <br />Owner Mailing Address City Zip Phone <br />Ppplicant MailingAddess Ciry Zip r'hono r� <br />Describe Proposed Work <br />PROJECf ADDRESS (if known) <br />no`u hnuwe <br />Lnne <br />N00054515 <br />Attach four (4) copies of plans lor proposed work - Draw to scale and note the following if applicable: $j�CHI�G �F. SD <br />•Property Lines 'Outline and dimensions cl all existing and prcposed stmctures on the lol •Existing and p�� f�tilitie;`p � <br />'Centerline of street •Indicate NoAh •Show any proposed grading changes •Show measurement:i qppppq3?9 <br />— DO NO � wHl i t ttt�uw i rti� urvt y000:1042 <br />PERMITCONDITIONS: c,e�� g�p,pp <br />1. All calls for inspection shall be made 24 hours in advance - phone 259-6310. ry <br />2. All work shall be performed in accordance with this permit and current City of ���� D��i49� <br />Construction Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-8Cd-424-5555. <br />1 �\s p�r ��uhlic workn arpro��ecl site pl.ui. <br />� luniall sm iutiltraition trench buiit t�a {�er Seciiou 3• 2.ti.2 .wd Figiuc mid'rable 3-2.2 of Ih� citv <br />`3lorw��sd� r hl�w:�emrul bi.uw�il (copy's stjy�le�! to !his perniil). 'I'lie i�dillrntiou lrruch ;hnll be <br />� Ins� r lh;m s t� el lo :my' np :;lope pro��erly liue oi tbiwdation uor closrr Ucm 10 feet to an}' (:O�171 <br />��rn��,,iie liur nr tonudati�m f'sdl Pnl,lic �Vorks lin ;m in:�icctinn ��riar �o cov�.riqn, trt•nrhr�• <br />Ap ved IocConsypction �a�e <br />. / <br />!� i ; ___� _ � • / 9 - 7� 7 <br />FINAL INSPECTION Date: <br />Approvad as Constructed <br />W <br />�iiF k <br />��/� <br />V♦ <br />� <br />dq <br />♦ <br />� <br />O <br />♦r^ <br />Y/ <br />O <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harmles� <br />the City of Everett fmm any and all claims for damages, cosis, ezpensas, or <br />causes of action that may arise because ol installaLon and mainlenance of <br />the improvement or other righ4of-way uso hereto applied for and furiher agrees <br />to remove same upon notice �rom ihe Cit and to replace public property <br />damaged thereby. <br />� /, � <br />GSigna ure of pl� Dat <br />WORK AUTHORIZED BY hIIS PERMIT MUST BE STARTED WITHIN 100 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO <br />COMPLEfION. THIS PF:RMIT MAV BE CANCELIED BY THE CITY UPON ANY STOPPACE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />