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�,� <br /> � ~ . _. <br /> � <br /> o x <br /> ��� �/- 3�-Z9-S �Z-om�— <br /> Gumm worcn ve,mn. <br /> � 92/sseai <br /> ,�p Date2f1.91� � eiae.oem.•—.----- <br /> �f.1� qpplica�ion For TO POSTING�:�-,—�— p �imwi�ksFee a_� <br /> �A� pE R M IT t°,a�Faa <br /> � pUgLIC WORKS �essnpoi Feeae�a s_—_---- <br /> �o aa�a��a o�e s �o - — <br /> O Nt� � <br /> p�p Print or TYPe Only �� , . <br /> �'y� � � WA 98036 �� 356-2435 <br /> 21902 - 36th Ave W Brl�� phone <br /> �p.�y Fairmont Homes Inc ���y Z�v <br /> � Mailing Atldre$s � <br /> gH Owner <br /> �, ' �: `' <br /> $�� Owner � Zio ahone <br /> Mading Address <br /> City <br /> �y� qpplicant <br /> y 0�° residence <br /> �escri6e Proposed�Nork ConstruCt new sin 1e famil <br /> — �az�.�. a����� �.�. W <br /> H- <br /> _ _ <br /> Pmiect Address Of known) licable: � <br /> Attach four(4)cop�es of plans for Proposed wo�k-Draw to scaie and note�GQo1Sew�ne of stPeet <br /> � p�operty Lines • Indicale North <br /> • Oudine and tlimensions of all existing and � ghow any proposed g�atling changes � <br /> � propo5ed StruCturQs on the lot � ShOw mea5ufemZntS <br /> � � • �zisting and p�oposed Nilities O <br /> CDO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS � <br /> 1 1,All calls tor inspection shall be made 24 hrs in advance-Phone 259'8a�0. <br /> ��'• 2,p11 work shall be peAormed in accordance with this permit and current City of Everett Design and Constmctlon � <br /> Standards and Specitications. <br /> � 3.Call Loca�ion Underground Service 48 hrs.betore you dig.TOLL FREE NUMBER 1•80�'424•55�E P`�� O <br /> tj.'�XlSTINC� Dl\V ON 4��� p�- MJST �E 2EMOYE\ AND`S �� S4�D� <br /> � �(�'T'�} F�JLI.. F'FE\4HT GUR� �Ul:"�L" P'N� SI��EWA�..�`� <br /> � �� # 3o5a �30� . MovE ex�sT,�-x, � <br /> AT LO[.AT�OA) O'F NE�V 172.�YG�vA�{ SAUG�T 02 P-E Ip <br /> s Gu�2cS civYrQL $ 5 � DE ��/A`..K -c-o EKPF+.n�s�o�J �O�tJT. RE P�Pu= O <br /> �'� N�TN w15vJ D e�V cR�/a`( p.7 2oN AS PElZ s-rD �3�Z �Ma.x �•�•�H 20, <br /> (O. �Kt5Tl1JC7 �f DlZ1YE�V/�� S{-FAl1_ [3E (L�cY'l(��(E1� �NL!J ^ <br /> ii <br /> �I�I ��,s.DY -rc� ��Ov2 �T SAr*'lrcT"lME NE��/ �STU r.iE <br /> I <br /> � 1�.l STA Ll.E�7 . <br /> ACK•.`JOJJLED'aEMENT O�CONDITIONS <br /> �� � • The undersigned owner�apPlicant hereby agrees to hold and save harm- . <br /> `�j l�i less ihe City o+ Everet� from any and ail claims for tlamages. costs. <br /> gapense�, or causes oi acfion that maa arise because o� installation <br /> [� MA�3 `�Z and maintenance of lhe improvement o other ri9M-of-way use hereto <br /> applied r antl further zg�eas to �emo�e same upon notice `rom the <br /> � X M G�A Date Cily an �t replace public p��Perry dama9ed thereby. <br /> qpproved for Co uction � _ . <br /> � Z �_-�_ <br /> �.��� � �/ � � �— Date <br /> �� � Date 5��1 q licant <br /> FINAL INSPECTION Wp 'A RIZED BY THIS PEHMIT MUST BE STARTED WITHIN <br /> ApO�o�etl as Co�structed <br /> �� PUBLIGWORKSDEPAR'fMENT 1B0 DAYS DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> '�� 3200CedarStreel BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAV BE <br /> Everetl,WA 98201 GANCELLED BY THE GTY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone'259-8810 PROJECT OVER 90 DA�S DURATION. <br />