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1996 o � <br /> Deie 5-4-93 q,�� 17 PUEOc Worb Perme� _ / 'j O <br /> ApplicationFor ��� �OSTING Bi0p.0eol• 40475 <br /> PUBLIC WORKS PERMIT P°°��=W°�k.F°° <br /> T��.�F« s <br /> Les�/po�Fee Paie S <br /> Print or Type Only e.m��,o�e S Z u�j <br /> Everett School District 4730 Colby Ave Everett 98203 339-4226 <br /> Owner Mailing Address City Zip Phone <br /> Contact: Dykeman - H. Richard Heindel 259-3161 <br /> Applicant Mailing Address Cify Zip Phone <br /> Describe Proposed Work Site work for main building at Everett Hiqh School <br /> QnC/ 5���� lun.-.f' ��– �c%.,..ln,v Uo�:r..�� <br /> .. —� <br /> 241G Colby Ave � , <br /> Prolect Address(it knuwn) � <br /> Attach low(4)copies of plans lor proposed worY,• Draw to scale and no[e�he following as applicable: � <br /> • Property Lines • Centerline of siree� � <br /> • Oulline and dimensions of all existing and • Indicale North <br /> proposed structures on the lol • Show any proposed grading changes <br /> • Exi,ting and proposed utilities • Show measuremenls � <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS <br /> 1.All calls for inspection sha�l be made 24 hrs.in advance•phone 259•8810. � <br /> 2.Ail work shall be perlormed in accordance with this permit and current City of Everett Design a�id Construction <br /> Standards and Specifications. <br /> ' 3.Call Location Underground Service 46 hrs.before you dig.TOLL FREE NUMBER 1•800-424•5555. � <br /> � 5�1�' ��rn� fo f� �ohe �.���l<r��s O <br /> nf7Pro✓cd �n 8�0 -9.3, <br /> � <br /> � <br /> O <br /> a <br /> , ACKNOWLEDGEMEIJT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm• <br /> � . less Ihe Cdy of Everett Irom any and al� claims lor damages, costs, <br /> � expenses, or causes ol action that may arise because of inslallation <br /> t�G� � and maintenance ol �he improvement or olher right-oFway use hereto <br /> applied I r a d turther aprees to re ove same up/ notice Irom the <br /> A rove 1 � nstr� lion , i �� ale City ai� to re lace py,plic roperty maged t r y. <br /> j'< /J / <br /> ! �" �: 4:�-��---�-�'�-J� / / <br /> FINAL INSPECTION ' Date �/ � v � <br /> Approved as Construcled ig ature ot pplicant �� Date <br /> `�� PUBLIC WORKSDEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200CedarStree� 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett,WA98201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone:259�B810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PqOJECT OVER 90 DAYS DURATION. <br />