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Dete 12I4I92 � P„m��wa,wv��..}�T��_ r <br /> APP���e��o�Fo� TO POSTINGl�> 1�' �O DeDt . <br /> PUBLIC WORKS PERMIT P��To�Fee��� : — <br /> �eu�ooi ieeana 6 <br /> Print or Type Only Bel�nce Doe s 20�= <br /> Ken Berg 12617 36th Ave SE Everett 98208 3?7-7836 <br /> Owner Mailfnp Address Cily 7ip Ph�ne <br /> Applicant Mailing Address Cily Zip Phone <br /> De8crlbe Proposad Work New house <br /> 7727 Cascade Dr ✓ L07`c� O+� � /'02-1'y-�'/ � <br /> Prolect Addresa Gf known) =�=� � <br /> Allach low(4)copies of olans lor pmposed work� Draw to scele and note Ihe lollowing as appGcable: � <br /> • Property Lii�es • Centedine ol street � <br /> • Outline and uimer.:;.�i_ol all existing nnd • Indicale North <br /> proDosed slructures on the lol • Show any p�oposed gr�tling chenges <br /> • Exis�in�and proposed utllitiee • Show measurements � <br /> Hr <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1.All calls for Inapectlon ahe11 be mede 24 hra.In edvance•phone 259•8810. � <br /> 2.All work ehall be perlormed In accardencx with thls permit end current City ol Evarett Deaipn end Construclion <br /> Stendards end Speclfications. <br /> 3.Cell Locetlon Underpround Service 4B hn.belora you dig.TOLL FREE NUMBER 1•800�424•5555. �� <br /> � <br /> O <br /> � <br /> � <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIOhS <br /> D�t1 The undersigned owner/apP�icant hNreby egrees to hold and save harm� <br /> less the Clty ol Everotl Irom eny and all cleims lor demeges, wr�ts, <br /> /' evpenses, or causes of ection that may arise becnuse of installation <br /> -�-y� ` C� ey and maintenance of Ihe improvement or other�ight-ol�way use here�o <br /> `�Yy�� !° �2 ��2 applieA lor and lurlher agrees lo remova seme upon notice Irom the <br /> Approved 1 ' nst� Date Ci�y nA lo replace bhc pr erty damaBed �hereby. <br /> �' -e��¢�•C c �.� /i,/79 <br /> FI LI iION � � a�a - <br /> Approved as Consiruc�ed Signature ol ApPGcant Date <br /> � PUBLICWORKSDEPARTMENT WORH AUTHORI2E0 BY THIS PERMIi MUST BE STARTE� WITHIN <br /> 3200CederStreet 1H0 DAYS OF DATE PC-RMIT IS ISSUED AND THEREAFT[R IS TO <br /> Eierelt,WA9B201 BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAV BE <br /> Phune:259�8810 CANCELLED BY THE CITV UPON ANV STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAVS DURATION. <br />