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,� <br />� <br />TYPE OR PRINT ONLY <br />��� � <br />PUBLIC ORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Streat <br />Everatt, WABB201 259-8870 <br />p8fer 12/31/98 <br />Poblk Nbrke PxmN 1 <br />euia�rq permn • 61234 <br />PuWk Works Fee S <br />DOUG 6 CONNIE CAMPBELL 425 S CABOT RD EVERETT 98203 425-353-5322 • <br />�� Melling AAd/asa G�y zip � Pho�e <br />Appllcant Mailinp Atldrass Clty ZIP Phone <br />Describe Proposed Work <br />PROJECT ADDRESS (if known) <br />AND REMODEL <br />Attach lour (4) copias ol plane lor proposed work • Drew to seale and note thn folbwlnp H epplicable: <br />'ProPaity Lines 'Outlina end dimenslona ol all erlsting end propoaeU etnicturea on tM bt 'Exlatirp and qopoeed utllitbs <br />'CentMi�a of atreet •Indicate Nonh 'Show eny proposed prading chanpas 'Show maaeuremente <br />_.. .------- <br />PERMIT CONDITIONS: <br />t. All calls for inspection shall be made 24 hours In edvance - phone 259-8810. <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and <br />Construction Standards and Specifications, <br />3. Call Locadon Undergrou�d Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800-421-6666, <br />';iHLIC WORKt ���� <br />nor�qcauM�r <br />°j' ---� <br />�nr� • ---� ��g--�......,, <br />�`IO�: �� 5� cit Sewer -�r� -� ; s I�to�se w� I I be <br />b,; �t ov�e� �,j �e h�w �d�� �,�h . wln�,r�e -btie <br />57c�csa�r�✓ '� 5 w�dP,,r' �Ghe ndv �d���oh � � ��st <br />b� v�9r�� -� ►�� �+e U P.c. - ���� `�, �»,it <br />Ags . Sc,c_. ' <br />Approvad lor Conelructlon pB�e <br />F♦I.N,�AL INSPECTION Dale <br />.y.ylOVBd 89 COf191fIlCIBd <br />W <br />H <br />— <br />� <br />� <br />� <br />� <br />a <br />�o �i��T,-v,�:� r �t <br />/ ACKNOWLED6EMEM Of CONDfT10N5 <br />The undenpned owner/epplicant hereby epmes to hoid end save harmbse <br />tM CNy ol Everatl han any and ell clalme fa demapas, coats, axpensss, or <br />cauaes ol actbn thet may ariss hecause of Inetallatbn end maintenance of <br />the krprovernent a othx rqM-d-wsy we hereto e�pNed fa and hMher ep�sse <br />to ra�wve eame upon notke Irom tM Clry and to replacs pubNc p�ppMy <br />damaged theraby. <br />Slpneture of Appllcant Dets <br />WORK AUTHORIZED BV THIS PERMIT MUST BE STAqTED WIiHIN 180 DAYS OF DATE PERMR IS ISSUED ANU THERF.AFTER IS TO BE DILIQENTLY WR3UED TO <br />COMPLE710N. THIS PERMIT MAY BE GANCELLED BY iHE C11Y UPON ANY STOPPAOE OF WOqK ON THIS PRCJECT OVER BO DAYS WMTK)N. <br />