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��� <br /> H <br /> > H C~i� IJate 7-8-91 �; �f <br /> jY � ; � <br /> N� �� � .. Pun��c worM�parmn♦ <br /> y Appiication For ewa o�oi . 91/27274 <br /> "y� PUBLIC WORKS PERMIT PUDio�fee`BC : <br /> � �"1 � <br /> VJ h'� �.as.�oo�r.«v.�e S <br /> x o� Print or Type Only ea�A��eo�� s <br /> [�1 <br /> H C <br /> ON �y <br /> pfnn �0,� S[eve Sorensen 1014 Colb � Avc Everet[ WA 98201 258-1808 <br /> �H � Owner Mailing qddress Ci�y Zip Phone <br /> H <br /> i..i y Vikin Co s L•'verett WA 9a201 259-7250 <br /> (7 V1 H APPlicant Mailing Adtlress City <br /> ��N Z�p Phone <br /> �+ Describe Proposed Work GaraQe, 504 SF <br /> H t�i� <br /> HO [n <br /> Proiect Address(il known� 1014 o hv Avr � <br /> Attach lour 14)copies of plans for proposed work-Draw to scale and nofe fhe lollowing as aGPlicable� <br /> • Properly Lines • Cente�line of sfreet I <br /> • Outline antl dimensions ol all existing and • Indicale Norih � <br /> proposed structures on the lot • Show an <br /> • Ezisting and proposed utilities Y P�oposed gradmg changes <br /> • Show measurements <br /> DO NOT WRI1�E BELOW TliIS LINE � <br /> PERMIT CONDITIONS O <br /> /��. 7.All calis lor inspection shall be made 24 hrs.in advance-phone 259•8870. <br /> I 2.All work shall be peAormed in accordance wfth this permit and current Crty of Everett Design and Construction � <br /> Standards and Specil�cations. <br /> 1 �. 3.Call Lowtion Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1-80p•QQ43555. <br /> r � <br />�� C�' �� �o�� ��=r� �� ,�-�.�� <br /> O <br /> � �� � <br /> �� 7-i7-9/ /� <br /> / VI <br /> ���I Gdt'�-2 21. ..c� 92+ ��e �lc�r��/�7r �-�'i'` c-uP^.. S'�n�-.C�c��i'�v, O^ <br /> 1I�..te.�O.Z�' �n,F`1�u�ea o-P-�ila�T'=�v�?�,t-7` �' u/',�')w.*-�i /ljoc- fi <br /> ��/!'�l'�t�r� /t0 7��r2� �Gw�Ozi+v/��QC�rr��.<g � C'aa,Q! <br /> I � <br /> ' �� - <br /> " ACKNOWLEDGEMENT OF CONDI710N5 <br /> The undersigned owne�/applicant hereby agrees to hold and save hanm <br /> less the City of Evemtt from any end all claims for damages. costs. <br /> expenses, or cau5es ol action thal may anse because ol installation <br /> ��' and mainlenance ol Ihe improvement or oiher riph4o4way usc herrto <br /> �PProved lor Consiruction anPlied tor anA luriher ag�ees to remove same un�n noiice iro�n ihr. <br /> ' Date City and Io replace public property damaged thereby. <br /> FINAL INSPEC710N Dale �+.-�t��Y�(� <br /> Approved as Constructed Signalure ol Applicant <br /> � ������Dale <br /> '� PUBLICWORKSDEPARTMENT WOFiK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIIJ <br /> 3200CedarStreet 180 DAVS OF DATE P[RMIi IS ISSUED AND TH[REAFTER IS 70 <br /> Everett,WA 98201 BE DILIGENTLY PURSUED i0 COMPLETION. THIS PERMIT A1AY HE <br /> Phone:259-6�10 CAIJCELLED DY THE CITV UPON ANV STOPPqG[OF WORK ON THIS <br /> PROJ[C70V[H JU DAYS [JURAiIUN <br />