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u � <br /> � �P�icationFor �i —__— <br /> PUBLIC WORKS PFRMIT oate_ 8-29-96 <br /> PUBLIC WORKS DEPARTMENT� Public Worke Pemiit M ���Z� <br /> 3200 Ceda:Sireet $ <br /> Everett,WA98201 259-881� F7,iildingPemiitN _ . _�Z]�L—_ --_- <br /> T 7 r APR 1 817Gi � � �t � � � ' ���F�s _..�iS2� _ <br /> TYPE OR PRINT ONLV O �OS 1 I N ll ---------- __ _—_____—_ <br /> Lyle Blank PO Box 2266 Everett 98203 3'SS-4725 '" "� _ <br /> Owner Mailing Adtlress �� ty '� � Phone <br /> � �� <br /> Owner $ � � �� c�. � r`n � _ <br /> A{�plicent Malling Address City Zlp Phone <br /> Describe Proposed Work new house _ � � I <br /> iii <br /> � <br /> — V♦ <br /> PROJECTADDRESS(ifknown) 7726 E Caeino Rd Lot 2 SP OB-96 � <br /> 4ltach lour(I)copka o1 plane lor proposed work•�raw to scele end nata the following II applicable: O <br /> 'Property Llnes 'Outline end tllmenslons ol atl ezlsting end proposed struclures on the lot •Existing entl proposed utilltles <br /> 'Centerll;�e of atreel •Indlr.ete North 'Show eny proposed grading changes •Show measurementa � <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS: <br /> 1.All calls for Inspection shall be made 24 hours in edvance-phone 159-8810. O <br /> 2.All work shall be performed in eccordance with this peimit end cuRent Cfty ot Everett Design and <br /> Construction Standards and Specitications. <br /> 3.Call Location Underground Service 48 hrs.before you dlg. TOLL FREE NI�MBER 1•800-424-6565. � <br /> `}. ���S�hesil ind;v;dva I PRV �i'rus�n, r�,�+.�e�.5 �z,lvt,� on w���kr s¢r��ec � <br /> �-s�r -�'L��S �,o^�C, O <br /> S. �to�l�o�, run o-ff s�iz�ll k�c. d;Sc.�,n�cd dv -H�e• lcrFS a <br /> in��l�+'7'�-V-;an -f-re,�cl� ,�rPe,- -1't,e, e��c "K'ts�dr.r-�-�n ( K� <br /> I�w�S�'�' S��S{e.,.�'��G�rl 1:�.�.� ��S �ar �'l.c. lc+car�t'urt <br /> i n-�cr��n-f-�on bh -N�e lo+'s s;-4t ��1-z��� . �„e e,tYz.�c� �n�l�e. <br /> �"1 I �`I rGc�'IOvI ��`1C l'1 S�-rt�l� �e a�prowe-d � T ��4. R+�J' ��G <br /> r I V 1 � <br /> wLY�S inSI�CC��. �f��� ts:^ �SG'��-'fi� `�v`�01� -Jo CpVPtinJ. <br /> I J <br /> F ACKNOWLEDGEMENT OF CONDITIONS <br /> � �/�/� Tha undersigned ownedepplicant he�eby agrees to hold end seve hertnless <br /> ihe City ol Everett from eny end ell claims br demeges,costs,expensas,or <br /> vod or Consirucllon Oata --' causes of ection that mey adsa because of Instellatlon and melntenance ol <br /> App A the improvement or other rlght-ol-way use herato applie0lor end further agreos <br /> � ✓ /� G� i/�/– .� //9�4' dameged therebyupon notica from the Clty and to replece public properry <br /> �r�i i ��, » Q� <br /> F ALINSPECiION D e ✓�p/(�� <br /> Approved ea Constructed � � f Li% <br /> re oi Applicant Dete <br /> WORK AUTHORIZEO BV 7HIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DAT MIT IS ISSUED AND THEREAFfEH IS TO BE DILIGENTI.Y PURSUED 70 <br /> COMPLEf10N.THIS PERMIT MAV BE CANCELLF�01'THE CITY UP6N ANV STOPPA OF WOflK ON THIS PROJECT OVER 90 DAVS DURATIOPi. <br />