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� PUBLIC WPOgRKS PERMIT <br /> Dare_ Z-12-97 -� <br /> PUBLIC WOqKS DEPARTMENT —�Orn ' <br /> 320p Cedar Street Public Works PermR M ��v <br /> Everett,WA 98201 259-8810 <br /> TYPE OR PRINT ONLY TO POSTI N G N� � 4 �`�� Bullding permll p 54217 <br /> P�bu�wo�g F�a _59� <br /> _ Ostolaza Greg/Sandy PO Box 866 Woodinvill�p�g��g_OOdH ZS�J-53p1� <br /> ow„ar rnamr,a rwdress fax <br /> City 2ip Phone — <br /> Owner <br /> Applicent Mailinp Atldress <br /> City Zip Phone <br /> Describe Proposed Work office trailer <br /> �` , ., ,9„ , ,': , � <br /> �OOD54^19 � <br /> PROJECTADDRESS(if known) 2941 Cheetnut St ,;�;�0 <br /> . <br /> Atlach four(q)copias o1 plans for pmpoead work� Draw to scale and note Ihe Iollowing il appliceble: �;4:'i�4-; -�. M <br /> �Proparty Linas butline end tllmensions of ell exlsfing and proposed structures on tha lot •Existing and p �� 1 ^.y�IHties� � W <br /> 'Centedine o1 etreet •Intlicate North •Show any proposetl ratlin chan es • r��"'-�� _ O <br /> 9 9 9 Show meesuremenis r����,�,�. <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS: „•+�. " , L�. � <br /> 1.All calls for inspection shall be made 24 hours in advance-phone 259-f.810. Z <br /> 2. All work shall be performed (n accordance with this permit and current Cfty of Everett Deslgn and <br /> Constructlon Standards and Specifications. O <br /> 3. Call Locntion Underground Service 48 hrs, before you dig. TOLL FREE NUMBER 1-800.424-6555, <br /> �� �5�+�1 s��wtalk 4x.l��hd ex��;n9 c�ry����v on P,�{.y's � <br /> vll Ches��lut -Froh��. S��e�lk �ts Pe✓� st�ndard O <br /> � ��h �3O(v. �r�;ve�a� as ��� � la� �307. <br /> .5. t1'l�itn�2iiv, 10'Glear -�(-,-am ,�v.r,ter o�f� Se.we✓- w,d�v�-{o nearest a <br /> S�rv�u�, <br /> �o . I� s+�i I F�,d�rs�a r2�t L'n� (� l'�tGkedr.�o f s�d�w�I k Ca lo�a�tohs <br /> �vtie.vr � de� o-f More -�h�,� 3o i nu�,cs ex i sts -}-o -�-he 9 rzi�e <br /> beloW as dtrY.c�cd by f.l�� P�bl�� w�,rks ��s�e�-�or: <br /> 7, Inst�il s�dese.u�er ?s �r s�znda►� �,lrh #GoZ . C�II 33q-7�}o3 <br /> �P.G Prtor -Eo co�.t�.r�+�9 -l�.+�c ti -F'or�.n Tns�rC-�bn. <br /> 7 / ACKNOWLEDOEMENT OF CONDITIONS . <br /> �� The undersigned owner/epplicant hereby agrees to holtl end save hartnless <br /> Appro /or Co ctl � •� ihe City ol Everatt Irom any and all clalms for damagrs,costs,expenses,or <br /> ale causes ol actlon that mey prise because of installation end mnintenance of <br /> the improvement or other right-ol-way use hereto epplied lor and lurthe�agrees <br /> b ramove same upon notice Imm ihe City nnd to replace public property <br /> FINAL INSPECTIOI — '7 damaged theraby. <br /> Date <br /> MP�vod as Consirucled <br /> SignaturaolApp ant <br /> WORK AU?HORIZED BY THIS PERMIT MUST�E STAR7ED WITHIN 180 DAVS OF DATE PERMIT IS ISSUED AND THEREFj ER IS TO BE DILIGENTLV PURSU D TO <br /> COMPLEfION.THIS PERMIT MAY BE CANCELLED BY TI1E C17Y UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAVS DURATION. <br />