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Date� 85-9/ <br /> Pebl¢Workt Permlt a _, <br /> AppliCetiOn Fo� P�Op.Oept�__ <br /> PUBLIC WORI�S PERMIT P�e,��Wa�k•F« -- <br /> To1H Fee Z�_ <br /> Leu�oo�Fee P��O s <br /> Print or Type Only e.�a��so�a S 8G,80 <br /> SNOHOMISH COUNTY TEACHERS' CREDIT UNION 1718 Broadway Everett, WA 98201 258-6481 <br /> Owner Maiting Address City Zip Phone <br /> NEWLAND CONSTRLt .TtON C0. rNC_ a n u„�. nca verett. WA 98206 259-9�9t o <br /> Applicent Mailing Address City Zip Pnone � <br /> c� <br /> m <br /> Describe Proposed Work Remove Existing Nouse and Ga�,Qe' In;;tall New Parki ng o Fa i 'ry <br /> Includine Allev Imnrovements to �BTH S -i� <br /> ... � <br /> N S <br /> m <br /> � W = � <br /> mo <br /> Prolect AGdress(if known) 1728 Broadwax, R�r r Wp� � 0 3 <br /> m <br /> Aitach four(4)copies of plans 1or proposed work• Draw to scale and note the lollowing as applicable: � _� <br /> • Properry Lines • Centerline ol sireet m <br /> • Outline and dimensions of all existing and • Indicate North � o z <br /> proposed structures on the lot � • Sho,v any proposed grading changes a --1 <br /> � Existing and proposed utilities • Sh�w measuremenls � _ <br /> --1 N <br /> DO NOT WRITE BELOW TbIIS LINE K �t <br /> PERMIT CONDITIONS O � 3 <br /> 1. Atl calls for inspection shali be made 24 hrs. in advance- pho��e 259•881 5. = m <br /> 2. All work shall be performed in accordance wilh this permit and current City ol Everetl Oesign and Construction ' m in <br /> Standards and Specificalions v <br /> 3. Call Location Underground Service 48 hrs. belore you dig.TOLL FREE NUMBER 1•800•424•5555. � �m <br /> m �' <br /> y O Z � <br /> To !3� �o�f/ST.tUtTE!) f'E.0 ./>c-iJi✓s APi�.��':iEp �m <br /> A.�o i�.erFv �s�ss. � <br /> � � <br /> _ <br /> a <br /> z <br /> � � <br /> � <br /> � N <br /> 2 <br /> O <br /> a � <br /> � <br /> m <br /> F <br />� ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm- <br />� less the City ol Everetl trom any and all claims lor damages, costs, � <br />� expenses, or r.auses ol action that may arise because of installatiun <br /> �����t��, ���S. and maintenance ol the improvement or olher right-ot-way use he�eto <br /> � �s-Y applied for and turther agrees to remove same upon notice 1rom the <br /> Approved for Conslruction�,CjvEr��,Q��- /�Ed a1e City and to replace public pioperly damaged thr, eby. <br /> —��� �n c�/+`��jJ � L; t'.C// x� _' .Q <br />� �/'c/! �l �-121�' �- ��l�a-.� / '�'Cgs <br /> FIMA N PE�TION Date ��e <br /> Approved as Conslructed SignaWre of Applicant Date <br /> everett PUBL�C WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> � 3200 Cedar Slreet 180 DAYS GF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Evere�t.WA 98201 BE DILIGENTLY PURSI;ED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone: 259-8815 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 ]AYS DURATION. <br />