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Date 10-08-91 / �/� <br /> Tn �n�Tl�(�—_ 1_� _n � PUELCWorkePermili ___(� /__�� <br />, Application For �J t� � V "_�__,��_ emo.oeo�.r_21/2790_= <br /> PUBLIC WORKS PERMIT PeblkWorkfFpa <br /> ' ' TotelPoe 5���� <br />� P(Int Or .r � �af�AGG4 Fee PaiE S <br /> IYPe Only � ea�e��oo�o y 2S0"�— <br /> li Arthur Skotdal PO Box 5267 1 Everett 982p6 <br /> Owner Mailing Address � . . ..� City ;. ' . 259-4359 <br /> : � . Z'p Phone <br /> Dykeman Architects 1602,Hewitt 'Ave ' 1 Everett "9820If 259-3161 Chuck Oqden <br /> Applicant Mailing Address <br /> CiIY Zip <br /> Phone <br /> Describe Proposed Work FiVe sto bld <br /> � Project Address(if known) 2910 Co1hv * � <br /> � Attach four(4)copies ol plans for proposed work• praw to scale and nole the following as applicable: � <br /> • Property Lines • Centerline ot stree; � <br /> • Outtine and dimensions ol all existing and � <br /> proposed structures on Ihe lot � �ndicate North <br /> • Existing and propoced utilities • Show any proposed grading changes <br /> • Show measurements <br /> DO N07 WqiTE BELOW THIS LINE � <br /> PERMITCONDITIONS O <br /> 1.All calls tor inspeclion shall be made 24 hrs.In advance-phone 259•8810. <br /> 2.All work shall be pertormed in accordence with this permit and wrrent Ciry of Everelt Design and Construction � <br /> Standards and Speci(ications. ; <br /> 3.Ca�l Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1•800•424•5555. <br /> � /..A✓ rOL�GqG �tl�' � �) <br /> �� � ���� /z - z -9/ � <br /> � <br /> � <br /> � <br /> �. <br /> ACKNOWLEDGEM[NT OF CONDITIONS <br /> The undersigned owner/applicant hereUy agrees to hold and save harm� <br /> less the City cl Everett Irom any and all claims lor damages, cosls. <br /> expenses, or causes of action Ihat rnay arise beCause of installa�ion <br /> —n ' and maintenance of ihe improvement or other right-of�way use hereto <br /> A " ved or Cy stcuotiu 7 1e applied lor and further agrees lo remove same upon notice irom the <br /> ����/ City and to replace public property dam ged thereb <br /> /L�� _ � � �� .. /J <br /> FINAC INSPECTION pa1e �'JGLCL(/`�/ //���. i/ �� � <br /> AFProved as Constructed _L ��C J <br /> � Signature ol Applicant Date <br /> �+�� PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY TNIS PERMIT MUST BE STARTED WITHIN <br /> 3200CederStreet 180 DAYS OF DATE PERMIt IS ISSUED AND THEREAFTER IS TO <br /> Everett,WA98201 BE DILIGENTLY PURSUED 70 COMPLETION. THIS PERMIT MAY BE <br /> Phone:259�8810 CANCELLED BY 7HE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />