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Date Z-16-94 .. 4e�c 7 <br /> . ^ PuEue Werk�Pvmu• / � <br /> Applleatlon For BWp.D�O�• 43541 <br /> PUBLIC WORKS PERMI �°;;,;F•,F�� � <br /> u..�oo�Fw v.ia t <br /> � p p p p R���nn Du� ` 2 Q va� <br /> Print or Type Only o in o v, -• <br /> w �� � � <br /> .. .. <br /> Roger Wilmon 2505 Cleveland Ave Everett �920 252-6852 <br /> Ownei MalHnp Atldresa �CI � 2ID Phone <br /> Goode Conet dba NW Garage 11217 60th St N �v� 98258 334-9262 <br /> Appllcent Meilinp Address Clty Zip Phone <br /> Deecribe Propoeed Work new gaiage <br /> Pro�ect AAdrese(11 known) 2505 Cleveland Ave _ � <br /> Atlach lour(4)copies ol Dlane lor propoaed work• Drew to ecele antl nole the lollowlnq ae applica6le: � <br /> • P�oparty Lines • Centerllne of etreet � <br /> • Outline and dlmenelons ol ell exletlnp and • Indicete North <br /> proposed etructure6 on the lol • Show pny propoaed predinp chenpes <br /> • Exlatinp end ptopoaed utllltlea • Show meesuremente � <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1.All cells for Inepectbn ehall be mede 24 hrn.In edvance-phone 259-8810. � <br /> 2.All work ehell be peAortned In accordence with thle permit end current City of Everett Desipn end Conatructlon <br /> Standerde and 3pecilicatlone. <br /> 3.Cell Locatlon Underpround Service 4B Are.belore you dlq.TOLL FREE NUMBER 1$00-424•5555. � <br /> `r; �1� LaGe O�- �elvicet�`c SC'/¢f��,�zr fo /yiee7` O <br /> 7 /JC L/��/�Orn-� P��s.oG/n9 CvO�e <br /> � <br /> � <br /> O <br /> a <br />� � ACKNOWLEDOEMENTOFCONDITIONS <br />, The undersigned owner/applicent hereby ap�ees lo hold and aeve harm• <br />� lese the City ol Everett Irom eny and all clelma lor dameges, costs, <br /> expenae�, or caueas ol actlon Ihal may erlas becauee ol Installallon <br /> �� �� z�.,/�K and meintenance of the Improvement or other right-ol•way uae herelo <br /> ���� `� epplied lor and lurther egreen lo �emove name upon nolfce 6om Ihe <br /> Approved lor Cone ruction ate Cify end lo place publlc p�opeAy demaped Ihereby. <br /> FINAL IPlSPECTION Date " �^ q <br /> App�oved ae Conatructed Sipn ure ol Applicent Dete <br /> � PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PEPMIT MUST BE STARTED WITHIN <br /> 3�OOCedar9treel 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everet4 WA BB201 BE DILIGENTIY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone:268-8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WOFK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />