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Date 4-17-95 <br />A imicabon For <br />PUBLIC WORKS PERMIT <br />Prin' or Type Only <br />Everett School District 4730 Co <br />Owner Mailing Address <br />Public WON$ Perm) <br />Bldg Dept • 48082 <br />Pebec WOKS Fee <br />TOtel Fee <br />Less sour Fee Paid S <br />Balance Due S <br />Ave Everett 98203 339-4350 <br />City Zip <br />Finley Architects, Steve Butterfield 258-6471 <br />Applicant M.Ainn Address City Lp Phone <br />Describe Proposed Work one portable Evergreen_ RHddle School_ —_ <br />Project Address (it known) 7621 Beverly Lane _ <br />Attach four 14) copies of plans for proposed work - Dray to scale and note me following as applicable: <br />• Property Lines • Centerline of street <br />• Outline and dimensions of all existing and • Indicate North <br />proposed structures on the lot • Show any proposed grading changes <br />• Existing and proposed utilities • Show measurements <br />OW TH <br />PERMIT CONDITIONS <br />1. All cells for Inspection shall be made 24 hrs. in advance - phone 259.881 O. <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and Construction <br />Standards and Specifications. <br />3. Cell Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1.800.424-5555. <br />PUBLIC WORKS PERMIT <br />NO REOUIRE4 <br />illy _„_ B <br />GATE s <br />Approved for Construction Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />CLPUBLIC W0gKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />Phone: 259-8810 <br />W <br />1 <br />• <br />z <br />Q <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the City of Everett from any and all claims for damage& costs. <br />expenses. or causes of action that may arise because of installation <br />and maintenance of the improvement or other right-of-way use hereto <br />applied for and further agrees to remove same upon notice from the <br />Cdy and to replace public property damaged thereby. <br />Signature of Applicant Date <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 PERA!IT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />