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4 <br /> � � � <br /> A f_i � , , �> _ ,,����U �— s � <br /> -; � D31B 5 28 91 . � •�' ���e���wnn�n.,m���--- <br /> � �y TO POSTING__;?�n...� emooso� • 91�Z�Ob� --- <br /> j <br /> Avplicotion For — <br /> � PUBLIC WORKS PERMIT ^°°°°w°„�`°° <br /> �< s___-- <br /> 'O ��tl roi.i r� .�.-- �� <br /> i..�enni vee rnn S_ <br /> y n�i.,�..m�. S__ <br /> � x Print or Type Only <br /> Q � ----- <br /> H <br /> � �g <br /> �t Jim DaGroot 1517 Broadway Everett 90201 889t88X 339-1525 <br /> HM — <br /> n�-1" n Ownor Mailing Address Cdy Zip Phnn? <br /> Z H <br /> �, y Owner _ --- — --- --- <br /> yAppliwN Mailing AdAress Cily Zip Pimm� <br /> g�� - -- <br /> � DesCrlbe PrOpoSed Woik _ �nSLLUCt new single family residence - - — — <br /> O� <br /> __—_'— � <br /> Prolec�Address lil knownl _�lf�Qil �l..vF+l nnd ,�•��- —__--- --- � <br /> A�Ipr,h lour 14)copies ol plans lor propoeed wnrk� O�nw lo scale and note Ihe lollowing ns applicabl��. � <br /> • Properly LineS • �nntorline ol Slreel /A <br /> • Outline and dimens�ons ol ell tfeislin9 nnd • Indicnte Norih V� <br /> propo5etl SIruClures on�he lot • Show any propo5ed c,�raAiny i:han9es <br /> • Ezisling and proposed utililles • Show measurements /y� <br /> W <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> t.All cxlla for Inspection shell be meda 24 hrs.in advancr, �phone 259•8810. � <br /> ���� 2.All work shall be peAormed in eccordance wilh this permit and current Ciry ol Everett Design�ntl Cons�mction <br /> Standerds enA Spetllicallons. <br /> . j 3.Cell Loaelion Unaerground Service 48 hrs.beln•e you dig.TOLL FREE NUMBER 7-8UJ•424•5555. � <br /> � �� � �� C r��•ICr l C�C•�i�t .�r� .� , L.� . 1� . . i � � <br /> � /) <br /> � . .� /"�'/^ �U/" LUQ.�c'.� C/�arfS a C�afc� SL'rv.cc O� v9 <br /> I /7outc 7�n fl,� I�!�r�h Cros/.k^5 Dl�er �hiS L��f: T�l�' � <br /> � ���iC4n� iJ�US� �Q�e .STr:�l fd Yc'�cifrifL" C✓tt f['i- � <br /> �� <br /> Liil�" ni- �.•��✓../e• a.� e�.tsc•i.-,�n' . � <br /> �, 1�1�1 a <br /> , <br /> � �1_1 ���� ACkNOWL1:DGEMEN7 O�CUNDI71ON5 <br /> �, �� 7he untlorsignetl owne�/epplicanl hc�eLy ayrens iu hold antl save hnnm <br /> --�---- ----'-------"-- !rss Ihe Cily ol Evnrelt liom any and all claims loi dainaqr,s. c�.usis <br /> exponses, oi causes ol aetion Ihut may arise ACC8115C ol inslnllntion <br /> �l L � - �nd maiNennnce nl�he Improvement or olhe�n9hbo4way use hereto <br /> �� ((Ll.,� � ��'� �� � _ - �� 0(Ip��Rd 101 df1f11UlihOl qqIBBS IO f¢If10VP. 6Af110 U�lO�1 nO�u'�'- �1Onl IhC <br /> ApPmv tl lor Constroc�iof� �ale �,iv;,w�o-,,,n�ace u�����c nrone�rv� ma{7eA IherrUy <br /> /� J ' l �i • <br /> l` p' �"_ " // - 5 ''/ ��.�i .� ' , <br /> 1� = - �---- <br /> �INFLINSPf.CTION Dale ---�" ��..=�� --------- <br /> Approved ns ConslructeA alw I Apnlicanl ����" <br /> �7� 7 PU�LIC WORKSDEPAPTMENT W��K'AUIHOR17[D �V THIS PERM17 MUST BG STARTED WITIUN <br /> , IAUDAVS Of DAiE PCRMIT IS ISSUFO AND 7HEREAFTER IS 10 <br /> :i?OOCeda�Slreel E�[ DILIGENiIY PURSIIE[7 10 COMPLCTION. TF'IS P[H�dl� MPV H[ <br /> Evwn�L WA!1B'101 CANCCLLH)F3V 7NC CI1V UPON ANV STOPPAGF Of WGRH ON iH15 <br /> Pbom, ?59-HH10 PNOJEC7 OVLR 90 D�15 DUR4110N <br />