6608 CADY RD 2016-01-01 MF Import

Date 8-1�-93 TA Iy�,/�1 /� �^ p � � 1�./ I ll.l!I�V...�— �� Puoi�c Worw�Pe.ml,;l 7�a� ✓ /Q Applicetion For niap oeo� •_� PUBLIC WORKS PERMIT PubLc Worhe Fee Totel Fee = �� Leae�ppl Fee Pem Q�— Print or Type Only a__�� v� 9abnq Due �'�Z �zzvciiy�/ Wally Jacobsen 6608 Cadv Rd Everett WA 9R9nz Owner Madmg Address Cily Zip �—�_ f hone D 6 B Conetruction 5001 135th P1 NE Mar�ville Wp 98271 1�53-8799 Applicant Mailing Adtlress C��y Z�� Phone Describe Propoged Work �ew $BtegE �—_ ___ _ �—_ Prolacl Address�il known) 6606 Cedv Rd W Attach lour(4)copies ol plens lor proposetl work-Draw to scala and note the lollowing as applicab�e: � • Froperty Linea • Centerline of sVeet � • Outline and dimenaions of ell existing antl � proposed etruCtures on Ihe lol � ��dica�e Norlh • Exisling and prop�sed ulilitiee • Show any proposed grading chenges � • Shaw measuremenls DQ NOT WRITE BELOW THIS LINE m PERMIT CONDITIONS O 1.All cells lor inapection ehell be made 24 hrs,in eavance•phone 259•a810. 2.All work ehell be peAormed in eccordance wilh this parmit end current City of Eve�ett Dealgn end Conetruction ' StanderCe end SpeciHcatlons. 3.Call Location Underground Service 48 hra,belore you dig.TOLL FHEE NUMBER 1•8 00-424•5555. � O � � O � a �,� ACKNOWLE�GEMENT OF CONDITIONS The undersigned owner/epFlican�he�eby egreea to hold and seve harm- less ihe City ol Everett Irom any end all claims lor damages, cosis, , � eMpenses, or causos of adion ihal may arise because of inslallalion � %�,_l�(�+*�!-:_ ��i�� and maintenance of fhe improvement or other righl-o4way�se hereto Approved lor Co��at�uction applietl for and luriher agrees lo remove same upon n�ticn hom the /� / Dale City and to replace pubhc property damageA thereby. ./"—f'�� " FINAL INSPECTION /" ' /r�-)'S Approved�s Constructed Date � ��.� Signatur�� Dale ' �'�' PUBLIC WORKS DEPARTMENT WORK AUTHOR12ED BV THIS PEFMIT MUST OE STARTED WITHIN �� 3200Ceder51ree1 190 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS 70 ��r Everetl,WA 98201 BE DILIGENTLV PURSUED TO COMPLETION. THIS PERMIT MAY BE Phone:259�8810 CANCELLED BV THE CITY UPON ANY STOPFAGL OF WORK ON THIS PROJEC7 OVER 90 DA�S DURATION.