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Date 1-6-9'i <br />TO POSTING_ I� k� <br />Application For vJ <br />PUBLlC WQRKS P�RMIT Z`�° <br />Print or Type Only <br />PuoLc WorNa Permlt � —1 � I I O // <br />Biaq Deo� • 3 7 <br />Pu01¢ Workn Fee - <br />To�ei Fee S <br />Lev FpDL Fee PeiO $ <br />�O <br />BflldllCO�UG �� � <br />an Construction PO Box 2153 Everet[ WA 98203 652-5761 <br />[u <br />Bob Champion 3801 Colby Ave Everett WA 98201 259-3136 <br />Applicant Mailing Atld�ess City Zip Phone <br />Describe Proposed Work new 5 uifit co[1do <br />Prolect Address (il known) <br />Lane <br />Attach lour (4) copies ol plans lor proposed work • Draw to scale antl note ihe following as applicable: <br />• Proper�y Lines • Centerline ol st�ret <br />• Outline and dimensions ol all exisling and • Indicate North <br />prop�sed slructures on the lot • Show any proposed grading changes <br />• Exis�ing and proposed ulilities • Show mezsuremenis <br />PEFM'T CONDITIONS <br />1. All calls lor inspection shell be made 24 hrs. in advance • phone 259•8810. <br />2. All work shall be perlormed in accordance wilh this permit and current City ot Everett Design and Construction <br />Standards and Specifications. <br />3. Call Locetion Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800•424•5555. <br />�, f�5 P�r apP�'o�cd �I�s ela� Oc� �l, �92 dnd Y�cviSec� 3-23�93 , <br />5�, P✓ovtd� br�hk,l�c, ��i-�o� d�'a��ac� a-f� Park�n lot oc�5ide <br />�-rrmetcr of bu�Id+h� .��,ru �u .vatl -+A �c. �n�I�rakr-dn-I��l, <br />FINAL INSPECTICN <br />App�oved as Consirucled <br />�A�I�� PUBLIC WORKS DEPARTIdENT <br />3200 Cetlei Streel <br />Everett, WA 98201 <br />Phone:259�8810 <br />The undei <br />-- less the ( <br />e■ nses. <br />, 3 I" 93 an aint <br />aG �� d o <br />Datc Cit a id c <br />• �/ Date _� <br />W <br />� <br />� <br />ACKNOWLEDGEMENT OF COND�TIONS <br />ed owner/applicant hrreby agrees to hold and save harm- <br />ol F.vere�t from any and all claims for damages, costs. <br />auses ol action that may arise because of installation <br />ce of ihe improvement or other right-of�way use here�o <br />lurther agrees lo remove same u�on notice f�om the <br />i a�e pu6lic property damaged thereby. <br />WORK 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 MPV BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAVS DURATION. <br />