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� <br />TYPE OR PRINT ONLY <br />Appl�cation Fnr <br />PUBLiC WORKS PERMIT <br />PUBLIC VlORKS DEPARTMENT <br />3200 Cedar Streel <br />Everctt, WA 98201 259-8810 <br />�� �OSTING - °--�� <br />i <br />Date___ 12/23/96 __ ' <br />-, <br />Public Wo�ks?e�mit q .__ 1��� �"�1/� <br />`�`--- <br />Building Permit 8 <br />Public Works Fee $ ___?[� <br />DUTNER BSILL 14 BEECH ST EVERETT 98203 347-1596 <br />Owne� Mailing Addres� City Zip phnne <br />Describe Proposed Wcrk <br />PROJECT ADDRESS (if knowii) <br />Address <br />NEW <br />2 � g��� _< <br />City Zip <br />Attach �our (4) r.oples ol plans lor proposed work - Draw to scale nnd no'e the lollowing It applicable: . <br />•Proporty Lines 'Outline and dimensions ol all exlsting and proposod structures on ihe lot •Existing and pi0poedA.utilities , <br />`Centedine ol street •Indicate North •Show any proposed grading changes •Show measurements � -� . . , � � <br />�� <br />� <br />�v i�v � rrni � c o��vrv i nio uivc . <br />PERMIT CONDITIONS: - <br />1. All calls for inspection shall be made 24 hours in advance - phona 259-8810. ;., - � <br />2. All work shall be peAormed In accordance with this permit and current City of Fyerett Dos'gn and <br />Construction Standards s�d Specifications. <br />3. Call Location Underground Servica 48 hrs. before you dig. TOLL FREE NUMBER 1-800��4-5555. <br />�% ln s�fr'i �l c j'ao f cfowns�.t ,'�-%l�:>.{rdh S� J%�!+ .s•s�'r fhc? <br />de�z��" 1 f Siz � r� ,�-, �'rr� fi«-r, 1�f,-�r le�� fh ; s �Oer.�,; � <br />W <br />H <br />- <br />� <br />r� <br />v� <br />� <br />a <br />ACKAIOWLE:7GEMEP;i OFCONDITIONS <br />The undersi3ned owrer/aopli,ant hereby agrees to hola and save harmless <br />ihe Ciry ol Everett bom any and all claims lor damayes, cosis, e.penses, or <br />causes of aclion that may anso because of installatbn antl malntenance of <br />the impmvPment or othar righl-o6way use heroto applied tor and furiher agrees <br />to removn same upon nc�ice Irom the City and to replace pu6lic property <br />daniaged thareby. <br />�1���� <br />Siqnatule n� Applicant I �e <br />i� �RK AUTHORIZED UY THIS PERMIT MUST Bc STARfED WITHIN 18C OAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE OILIGENTLY PURSUED TO <br />CO� �PLEf101J.1NIS PERMIT MAY BE CANCELLEU BY THE CITV UPON ANY STOPPAGE OF WORK ON'i HIS PROJECT OVER 90 DAl'S DUR 4TION. <br />