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p8�@ 11-12-93 n n�T �– � –� � PuE��e War��Permn• '7 3�/y� <br /> TO �N�_ 5 —L3-9�( a��o o.o� . 4266R-- <br /> Appllcellon for <br /> PUBLIC WORKS PERMIT P�����WorR�Fee -- <br /> Tol�i Fse d� <br /> lN��pD��Fea PuC s � <br /> � Ba���u Uue { <br /> Print or Type Only <br /> �_;;� <br /> The Co�onwealth Group 15009 40th Ave W Lynnwood WA 98037 742-A727 �`� <br /> r,._ <br /> Owner Mal{ing Atldress City Zip Phone <br /> (i'rd <br /> Owne r ,';;� <br /> Applicant MellingAdtlress City Zip Phone � ��'y"t� <br /> \ <br /> Deacribe Pioposed Work new house lot 1 of ahortplat 16-93 �'t� �� <br /> i:�. <br /> ;k:'a <br /> . , <br /> /� W ' � <br /> Pro�ect Addrese(lf known) �f/yZZ — �`d�� ��a[� � <br /> Attech four(4) caplea ol plena for proposed work• Draw to scele enA note the lollowing ae applicable: � <br /> • Property Lines •Centerline ol st�eel � <br /> • Outline and dimensions of ell exiatinp and • Indicate North <br /> proposed atructuree on Ihe lot • Show eny proposed greding chenpes <br /> • Exleting end proposed utllitlee • Show measuremenla � <br /> DO NOT WRITE ELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1.All cells lor Inapection ehell be mede 24 hrs.In advence-phone 259�8810. � <br /> 2.All work ehall be perlormed In eccordance with lhie permlt end current Clly ol Everett Deelpn and Conetructlon , . <br /> Stande�de end Spec�ficatlone. �� <br /> 3.Cell Lxatlon Underqround 3ervice 4B hre.belo�e you dlg.TOLL FREE NUMlER 1•800�424b535. � <br /> O <br /> � <br /> � <br /> O <br /> a <br /> � ACKNOWLE�GEMENT OF CONDITIONS <br /> � The undersigned owner/applitant hereby agieea to hold end eeve herm• <br /> less the City ol Everett I�om eny end all claima lor demeges, cosls. <br /> � //� A I 7 eKpenses, or ceuaes ol aclion thot mey erlee becaune ol Instelletion <br /> ��� D L.�I� (V�f Z 3'9J end malnlenance ol Ihe improvement or other rl t•ol•way uae hareto <br /> ��ti� epplied lor and fuither egrees to remov sa pon notice Irom the <br /> Approve lor Constr ction Dete Cily and to replac bGc r erty de pe h reby. <br /> 1. � 3- ?J. '1y/ <br /> FINAL INSPFCTION Dete i <br /> Approved ee Constructed Si ture o�Applicent� Date <br /> WORK AUTHOHIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> � PUBIICWORKSDEPARTMENT 18D DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200Ceda�Street 8E DILIOENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Everett,WAB8201 CAfICELLED BY THE CITV UPON ANV STOPPAGE OF WORK ON THIS <br /> Phone:259�8810 PRC�JFCT OVER 90 DAVS DURATION. <br />