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� <br />� <br />TYPE OR PRINT ONLY <br />Owner <br />qpplitant <br />• 'rcation For <br />PUBLIC V6 JRKS PERMIT <br />Describe Proposed Work . <br />PUBLIC WORKS DEPARTMENT <br />3200 CetJar Street <br />Evereri, WA 98201 259-8810 a Z� <br />� <br />Plan Check No: 52516 <br />Applicat.Date: 07/96 <br />Job Addre: COLBY AVE <br />Owner: JACRSON BOB 6 <br />Tenant: <br />PrOpoBed Uae: GARAGE <br />Deec. of Work: <br />NEW DETACHED GARACE <br />OFFICE SET <br />Date _ <br />Public Works Pertnit p <br />Building Pertnit M _ <br />Public Works Fee $ _ <br />SEPA <br />DEBBIE <br />APPRVD FOR PERMIT: DATE_/_/_ BY <br />PROJECT ADDRESS (if known) <br />Phone <br />Attach four (4) copies of plans for proposed work - Grew to swle and �ote the following H appliwble: <br />�Property Llnes 'Outline and dimensions ot all ezisting and proposed structures on the bt •Fxisling and proposed utilities <br />�Centerline ol street •In0lcate Nortti •Show any proposed grading changes •Show measurements <br />PERMIT CONDITIONS: <br />1. All calls for inspection shall be made 24 hours in advance - phone 259-8810. <br />2. All work shail be performed in accordance with this permit and current City of Everett Design a�d <br />Co�struction Standards and Specifications. <br />3. Cali Location Undergreund Service 48 hre. before you dig. TOLL FREE NUMBER 1-800-424-5555. <br />+'UBLIC WORKS �ERMIr <br />IFO'� REOUIR6i <br />BY1� _. _. <br />r qTF _ ___3�- :A_. w�_._. <br />Appmved for Conslruetion Daln <br />FINAL INSPEC710N Date <br />Approved as Constructed <br />�� <br />V ♦ <br />O <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned uwner/applicznt hereby agrees to hold and snve M1armless <br />the City o1 Evereil from any and all claims for damages, costs, expenses, or <br />causes of actior that may ansa because of Installalied for�and funher�agrees <br />the improvement or other right-of-way use M1ereto app � <br />to remove same upon notice trom the City and to rep�ace public property <br />damaged thereby. <br />Signature of Applicant Date <br />OM LETION.TIN SDPLRMIT MA YBE CANCEIgI.[D BVT i�E CITYIUPON �ANY SOTOPPAGE Of WORK ON TMS PROJEC OVER 90 DOAYS D�UIRIATION.Y PURSUED TO <br />