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��� <br />a � <br />��� <br />�a��a <br />��� <br />x <br />oMr� <br />1"1 � <br />Q�yr <br />ZsN <br />t" y <br />N <br />� <br />�y M <br />W w <br />�� <br />Date <br />rL� J/ <br />.S—Z3- _S <br />Application For <br />PUBLIC VIr'ORKS PERMIT <br />Print or Type Only <br />Pu011e WorM� Parmll • /� <br />BIap.Oapl e �l.'� <br />PUEIIe Works Fea <br />Totel Fea S <br />Lus �OG� Fea P�iE �i <br />Bslence Oua S <br />rian unncx no: � qiLut SEPA <br />Applicat.Date: 06/30/92 <br />Job Addre: 2218 FIRLAND PL <br />Owner Owner: DAVIES DEAN 6 SANDRA Phone <br />Tenant: • <br />Propoeed Uee: SINGLE FAMILY RESIDENCE ' <br />Deec. of Work: <br />TWO LEVEi ADDN <br />Applicant Phone <br />OFFICE SET JOB SET <br />Describe Proposed Work _ APPRVD FOR PERMIT: DATE <br />_/_/_ 8Y <br />Pro�ect Address (il known) <br />Attach four (4) copies of plans lor proposed work • Draw to scale and note ihe tollowing as epplicable: <br />� • Property Lines • Centerline ol sireet <br />• Outlina and dfinensions of ell existing and • Indicate Norih <br />proposed structures on the lot • Show any proposed grading chenges <br />• Existing and proposed utiii�ies • Show measurements <br />PERMIT CONDITIONS <br />1. All calts for Inspection shell be mede 24 hrs. in edvance - phone 259•8810. <br />2. All work sheil be peAormed tn accordance with lhis permft end curcent City of Everett Design and Constructlon <br />Stenderds and Speclfications. <br />3. Cell Location Underpn i Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800•424•5555. <br />! (/�Cti LtJL2<" � �Z! : .�r: �L/ /1� % ���[cc-;r t % <br />i � � <br />�., .; z <br />Approved for Construction Date <br />FINAL INSPECT�ON Date <br />Approved as Constructed <br />�A��PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Ererett, WA 98201 <br />Phnne: 259�8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />H <br />N <br />The undersigned owner/applicanf hereby agrees to hold and save harm- <br />less ihe Cily ol Everetl Irom any and all claims for demeges, cosls, <br />ezpenses, or causes of action that may arise because of installation <br />and mainlenance ot ihe improvement or other right•of•way use hereto <br />applied for and luriher agrees to remova same upon notice trom the <br />City and to replace public property damaged thereby. <br />Signature ol Applicant Dale <br />WORK AUTHORIZED BY TH�S PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PUFSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED EY THE CITY UPON ANY STOPPAGE Of WORK ON THIS <br />..�,.. �r-.�r n„rr. nn n�vc ni �onrinei <br />�� <br />; <br />