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� <br />TYPE OR PRINT ONLY <br />.pplrcatron For <br />PUBLIC ORKS PERMIT <br />PUBUC WORKS DEPARTMENT <br />3200 CeAar Street <br />Everetl, WA 98201 259-8810 <br />Dat� 8-18-97 _ <br />Public Works Pertnit M <br />Buiieing Pertnit N 56260 <br />Public Works Fee S <br />Tinney Jim/Lee 521 Colby Ave Everett 98201 353-7161 <br />Owner Mailing Address City Zip Phone <br />Everett Builders 353-7161 <br />Appliwnt Mailing Address City Zip Phare ^ <br />Describe Proposed Work <br />PROJECTADORESS (if known) <br />new detached , <br />521 Colby Ave <br />Anach four (4) copies of plans for proposed work - Draw to scale and note the talowing H appliwble: <br />•Property Lines 'Outline and dimensions oi aV ezisting and proposed structures on the lot •Eicisting and proposed utilities <br />•Center�ine of street •Indicate North 5how any proposed grading changes 'Show measuraments <br />PERMIT CONDITIONS: <br />1. All calls for inspection shatl be made 24 hours in advance - phone 259-8810. <br />2. All work shall be perfortned in accordance with this pertnit and current City of Everett Design and <br />Construction Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5556. <br />� <br />� <br />Approved for Construction Date <br />FINAL INSPECTION Date <br />Approved as ConsWcted <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harmiess <br />the City of Eveietl from any and all claims for damages, costs, expenses, or <br />eauses ot action that may arise because oi installation and maintenance ot <br />the improvement or other ngh4of•way use hereto applied forand lurther agrees <br />to remove same upon notice imm the City and to replace public property <br />damagedthereby. <br />Signature ol Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO <br />COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />