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11/6/BS �i <br /> �818 r„ei�c we�x.r���i n5678-- <br /> Application For Blep Depl . <br /> PUBLIC WORKS PERMIT �u�hcWOAefee <br /> Tolsl Fne f <br /> �P»APCI Fee Plid � <br /> Print or Type Only NaianceDue � 2'��� <br /> b��/3G <br /> Gene Cross 8612 Cascadia Evarett 98201 <br /> 338-0799 <br /> Owner Mnil�ng Address City Zip Phone <br /> Same <br /> Appllcant Meilinp Address Cily 2ip Phone <br /> Remodel to Three Unita <br /> Describa Proposed Work <br /> � <br /> � <br /> I <br /> P�o�ect Addraes(ff known) 2940 Cedar w <br /> Attach lour(4)copies ol plena lar proposed work� Diaw to acale end note ihe lollowing as eppliceble: � <br /> • Proparty Linea • Conle�line ol streat � <br /> � Outllne and dimenalons of all existing and � Indicete North <br /> proposed atrucluree on the lot • Show any p�opoaed grading changer, <br /> � Exletlnp end propoeed utlllties • Show measurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS O <br /> 1. Alt cells for Inspection ehell be mede 24 hrs. in advanca-�hone 259•887 5. � <br /> 2. All work ahell be performed In accordence with ihis pe�mit end current Cily ol Everett Desinn enA Conalruction <br /> Stendarda and Speclllcations. <br /> 3. Call Locetion Underground Service 48 hra. balore you dig.TOLL FREE NUMBER 1•800•424•5555. � <br /> f'.e.e.r�.r/� LOT <br /> 5! ro BE- �'avsr,c�cr�o ,nF,� A�>f�,�c,�F�� O <br /> /�Ld.r/S L�,erEt� //- �/-A_S: <br /> � <br /> Y/ <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> _ 7he undersignetl owner/npplicant hereby agrees to hold end save harm- <br /> leas the Cily of Everelt Irom any enA all clnims lor damages, costs, <br /> ^ expenses, or ceuses of aclion that may erise becauae ol Installetion <br /> y ����.�� ard maintennnce of Ihe improvemr�nt or other riphbo4wey uae hereto <br /> Approved lor Co etructlon — applied br nnd lurlher agrees to remove seme upon notice Irom the <br /> Dele Ci,y and lo replace public properry dameged Ihereby. <br /> - 3o - Y� 9 / <br /> INSPEC710N Date ��le��h��� JI�� <br /> Approved ea Conetructed �alwe �plicem Dete <br /> eve�ett PUBLIC WORKS DEPARTMENT �✓�RK AUT ORI7_ED B THIS PERMIT MUST BE STARTED WITHIN <br /> � 3200 Ceder Sireet 1B0 DAYS OF DATF PERM17 IS ISSUED AND TNEREAFTER IS TO <br /> Everelt,WA 98201 BE DILIGENTLY PUFSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone: 259-BB75 CANCELLED BY TlIE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PHOJECT OVER 90 DAYS DURATION. <br />