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TD PQSTIN6 _? -��.—. <br /> qppl¢aUon Fo� <br /> � PUBLIC WORKS PERMIT Date_ 1.�-��-9s ____ <br /> � / <br /> PUBLIC WORKS DEPARTM�NT Public Works Pormit M �/���--- <br /> 3200 Cedar Streel � � <br /> Everett,WA8B201 259-8�0 BulldingPermltl 50272 _____ <br /> T' .� � L�j j]� In ,�1 f� 1'� � � G� �) — <br /> TYPE OR PRINT ONLY �; � y c' .a 3 'a �'':ql�w'��6e�--(�� --- -- <br /> O p,� P M � M .� M i� (�J� [1 <br /> M M � �'� <br /> John D Sandere 15420 Mill Crk Blvd II�J=201 Mill' Creek�$012` "�142-8966 <br /> Owner Mailing Atldress � � City '� � "ZI� ? Phone <br /> � � i .' <br /> Owner � � � � '��' SE �� � �' $' � Cn �F_ --- <br /> Applicant Melling Address City 21p Fhone <br /> Describe Proposed Work _ new house _ - W <br /> — � <br /> � <br /> — \// <br /> PROJECT ADDRESS (ifknown) 6410 Cady Rd Lot 2 SP 1116-94 � <br /> Attoch four(4)coples ol plans for proposad work•Drew to scele and note Iha lollawing If eppliceble: � <br /> •Property Lines •Outllne end dlmensions ol all ealsting and proposed struclures on the lot •Ezisting and proposed utllities <br /> •Centerline of street •Indicate NoAh •Show eny proposed grading changes •Show measurements � <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS: <br /> 1.All calls for inspection shall be made 24 hours in advance- phone 259-8810. O <br /> 2. All work shall be performed in accordance with this permit and current City of Everett Design and <br /> Constructlon Stendards and Specffications. � <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. <br /> V♦ <br /> O <br /> a <br /> � <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> G /^ � _ The un�ersigned owner/applicant hereby agrees to hold and save harmless <br /> � � the Cit of Evnrett from any and nll clalms lor demages,cosls,expenses,or <br /> cnuses of ectlon ihat may arise because ol instellation and malntenance of <br /> Approved for Conslruction �a� the Improvement or other right-ol-way use hereto npplied for and lurther ngrces <br /> "' to remove same upon notice from the City nnd to replace public propeAy <br /> �l.'^� / � �/•�` damagedt by <br /> FlNAL INSPECTI0�1� `— Date � <br /> Approved es Conslructed , '� 'l � <br /> na re of Applicant Date <br /> COMPLETION.RTH SD ERMIT MA YBE C4NCEL�LED BVTH�E CIN�UP�N AN S�TOPPAGE OF WORK ON THIS PRO EC OVEER 90 DA S DULRATION.Y PURSUED TO <br />