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�:.� .. � . . . . i - . . . . ' _ .. . .__ . . <br /> PUBLIC WORKS����G DEC 1 S �9�16/9b <br /> r,.�. <br /> PUBI.IC WORKS DEPAFITMENT Public Work=Partnk M !G�3S.� <br /> . 3200 Cedzr Streat . <br /> Everett,WA 98201 %.59-8910 Building PemiN M 5$88� <br /> TYPE OR PRINT ONLY Pu51k Works Fee S � <br /> �p(GCC On iYlsi/� <br /> HOIISING 80PE PO BOX 7823 EVRP,LTT 98201 Sf� �����''�"�� <br /> Owner MeIlkpAddress Gly �Zip Plwne -- <br /> JERRY STICRNEY 623-1104 <br /> ApPlicant Mdl�ng Addresa Gty Zlp Plqn� <br /> 'De`scribe:Proposed Work � w-LTI—FAM'iLY COMPLEE PHASE I DRAINAGE _ � . <br /> � � �i <br /> �,`! � <br /> PRCJECT ADDRESS(if known) S73D — �RGt�$x wAY � <br /> Attbch tour(4)copies of plans for proposed work-Drew to scs�e and rwte the following If eppllceNe: O <br /> •Property Lines 'Outline and dimenslona of all exlsling and propoeed structures on the bt 'Exlating end pmposed utllkles <br /> 'Cent¢�Iino of street ■Indicete North 5how any propoaed grnding chenges 5how mseaurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS: Z <br /> 1.All calls for inspection shall be made 24 hours in edvance- phone 259-8810. O <br /> 2.All work shall be performed in accordance with this permit and current City ot Everett Desfgn and <br /> Constniction Standards and Speciflcations. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-6666. H <br /> � /N�i'� CO � �G� OOr�C �Q�" 4�orOv�d �Pry � <br /> d���� 9 -�-4-96 . O <br /> , ; : EL <br /> � � � � � <br /> a � <br /> S�P 2� 1996 <br /> .................................... <br /> CITY OF EVERETT <br /> Buflding Division <br /> Of T /SSU,C-C P,E,C� Fctiee�.-. ` mA <br /> �51CKNOWLEDGEMENTOFCONGfiIONS ' <br /> // 7 �j/ The undersigned ownedapplicant f�areby agrees to Irold and seve harmless <br /> /7Y0 ,���!� ��l�� ��,�/� ihe City of Everett from any and all clalms tor damapes,costs,expenses,or <br /> `����� �� ' � eauses of action that may arise because of Installatbn and malntenance of <br /> roved orConstructbn �DSte � thelmprovementorotherright-of•wayuseheretoapplbdforandfurtheragrees <br /> � to remove same upon notice trom the Cky end to replece public properry <br /> demagedthereby. <br /> FINAL INSPECTION Date � <br /> Approved as Constructed � <br /> r �" .1 6 <br /> Signatu � Deta <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATEfE ISSUED AND 7HEREAFfER IS TO BE DILIOENTLY PURSUED TO <br /> COMPLETION.THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPA�iE OF WORK ON THIS PR0.IECT OVER 90 DAYS DURATION. <br />