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� �i�cation For <br /> PUBLIC 1�►JRKS PERM17 De�! 11/13/96 <br /> PUBLIC WORKS UEFARTMENT Public Nbrks Pertnit N <br /> 3200 Cedar Street <br /> Everett,WA 88201 259•8870 <br /> Bulldinp Permlt M 59�2__ <br /> TYPE OR PHINT ONLY Public Nbrke Fee S_ <br /> _VIRGINIA NELSON—RUTER 19202 PAUK WY IYNNWon❑ 9An36 677_q469 <br /> Owner Malling Atldress Ciry Zlp Phona <br /> Applicanl Mailing Address City Zlp Phone <br /> Describe Proposed Work RF.MOVE EXI G ■ ■ ■ <br /> W <br /> � <br /> � <br /> � <br /> PROJECT ADDRESS(if known)�ZCHESTNl1T � <br /> Attech lour(J)copies ol plans lor proposed work-Draw to scale end�ole the lollowinp II epplicable: O <br /> •PRpany Lines 'Outline and dimenslons ol ell ex:sting and pmposed elructurea on ihe lot •ExisOnp antl proposed utllitles <br /> �Cen�erlina ol street •Indicale North 'Show eny proposed greding changeo �Show measuremenis � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS: � <br /> 1.All calls lor inspection shall be made 24 hours in advance- phone 259-8810. O <br /> 2. All work shall be peAormed in accorcJance with this permit and current City of Everett L)esign and <br /> Construction Standards and Specifications. <br /> 3. Call Locatlon Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-8668. � <br /> P�►;� �yo� ���- N�- �. � <br /> 0 <br /> �� �. a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The unAersipneA owneri�pp�icant hareby egrees to hold and eave harmlase <br /> Ihe Clty ol C�erett from any nnd all claims for Oemepes,coeta,expenees,a <br /> Approved lor Construction Date - causes ci er tlon Ihat mey adse baeaux of Inetalletion end malnlenance ol <br /> ihe Impmvert�c.�t or other rfpht-ol�way ux herato applietl lo�end}urther eproee <br /> to remo•�a same upon notice from the CHy and to replace public property <br /> damagad Il�areby. <br /> FINAL INSPECTION Data <br /> Approvad es Construaed <br /> Slgnature of Applicord Date <br /> Y/ORK AU7HOHIZED BY TH�S PER1A�i MUST BE STARTED WITHIN 1B0 DAYS OF DATE PERMR IS ISSUED AND THEREAF7ER IS TO BE DILIQENTLV PIIRSUED f0 <br /> COMPLFTIUN.THIS PEfiM1T MAY BE CANCELLED BV THE CITY UPON ANV STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAVS DURATION. <br />