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oete 6-7-93 rn pnStING_%! -S1-4 _(j�c"�,��/� �-- <br /> �' —Pu�ec Worhe Permit• T� /G <br /> Applicellon For BiOp Depl • 40833 <br /> PUBUC WORKS PERMIT Pubi¢WorF�Fcn <br /> TolelFee S <br /> leu�p0��ee PniC � ^O� <br /> Print or Type Only Belence Doe S �+� <br /> Whitt Mark 6 Liea 1207 Yew St Everett WA 98203 355-2066 <br /> Owner Melling Atltlress City Zip Phone <br /> Contact: Gene Holzechuh 337-1679 <br /> Applicent Melling Address City Zip Phone <br /> Descrl6e P�oposed Work modular house <br /> Projecl AJdresa lil known� 1105 CaeCAde Di � <br /> Attach lour(4)copies ol plans br proposed work- Draw to scale and note�he lollowing as applicable: � <br /> • Propeity Llnea • Centerline of street � <br /> •Outline anrf dlmensions of all exisling and • �ndicale North <br /> proposed st•uctures on the lot • Show eny proposed grading chang„s <br /> • Exislinp and proposed utililies • ihow measurementa � <br /> DO NOT WRITE BF.LO'N 1iIIS LINE <br /> PEFMIT CONDITIONS O <br /> t.n��caue tor�nepection shau be mede 24 hrs.�n e�vance•phone 259-881 O. � <br /> 2.All work shell be perlormed In eccordence wlth this pa�mlt and current City oi Everett Design ena Conatruction <br /> Standarda end Specillcatlona. <br /> 3.Call Locetlon Underground Service 4B hra.belore you dlg.TOLL FREE NUMBER 1-800-424-5555. � <br /> �j,� ZjstcLL �2 r Cd��.ratd CGCLve.�)` Und�•- drive�✓n.� O <br /> � <br /> � <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF GONDITIONS <br /> The undersigned owner/applicanl hereby ag�ees to hold and save ha�m� <br /> less Ihe Gtly of Everetl Irom any and all cleims lor tlamages, costs. <br /> n /� ezpenses, a causes ol aclion that may a�iae because of installahon <br /> '�,/��I �d�� /Q3 end maintenance ol ihe improvement or other right�of-waY use hevelo <br /> fQa� ���U�! applled lor and lurther ngrees to remove same upon nolice Irom �he <br /> ApOroved qConstruc'�lon � �ate City anA to replace pubG property damaged thereby. <br /> � � � <br /> � � a � <br /> INA I N,i p �e <br /> Approved es Consiructed Signe ure Applican Date <br /> � PUBLICWORKSDEPARTMENT WORK A THORIZED BV THIS FERMIT MUST BE STARTED WITHIN <br /> 3200CetlerSlreel 180 DAVS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TC <br /> Everott,WA 98201 BE DILIGENTLV PURSUED TO COMPLETION. THIS PERMIT MAY P <br /> P�one:259�BB10 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WURK ON T� <br /> PROJECT OVER 90 DAVS DURATION. <br />