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,, r <br />� <br />Data <br />Applicetion Fot <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Plan Check No: B 36338 SEPA <br />� 11pp1icat.Datas 4/13 92 <br />Ownei Job Ad�:=j��ER,MHONNIE <br />K <br />Tanant: <br />Ptopoeed Usei SFR CARAGE <br />Dasc. of Works <br />Applic GARAGB/POLS BLOG�720 8F <br />Dasc�ibe Pn � . <br />OFFICS SET JOB SET <br />aPPAVD FOR PfiRMIT: DATE_/_/� BY <br />Pro�act Address (if known) <br />.. .'.:."N'WMXr ii��,..rG,'.�+x.Kf:',J'�. <br />Pu44C WwM� PxmX • <br />ewc ow� • — <br />hONC WOMu FN <br />.w.i F.. s <br />Uu �ppl Fn MIO � <br />e.i.nu ou. 3 <br />.. _ . � .;."p,' <br />� <br />�'.I <br />Z�p Phone <br />Z�p Phone <br />Attach four (4) copfes ol plena for propoae+ work - Draw to scale end note the following as applicable: <br />• Property Linea • Centerline of atreet <br />• Outline �nd dlmensions of all exist��fl e�d • Indicate North <br />propoaed �truclurea on the lot • Show any proposed gradinq chanyas <br />� Existinq and propoeed utllitles • Show measurementa <br />PERMIT CANDITIONS <br />1. NI celle for inspectlon ahell be mede 24 hrs In edvance • phone 25&8810. <br />2. q�l wpAc ehell be performed In aaordance with this pertnll end curtent Ciry of Everett Design and Conatructlon <br />Stenderde �nd 3pecifiutlona. <br />3. Call Locatlon Underyround Servica 48 hn. be(ore you dip. TOLL FAEE NUMBEX 1-800�4245555. <br />���ua cta=�e(i�.�l- �co %l+' �-�-(;�f <br />5Yo �f ; f/�... ��r.o �u. G-Li�' <br />t.uJzf� /svr»�<� .<,> ,���ucti�o/ <br />�a <br />S�-ze- 97 <br />Approved for Construetion Date <br />`�. FINAL INSPECTION Date <br />{� qpproved as Constructed <br />PUBLIC WORKS OEPARTMENT <br />:����- � 3200CedarStreet <br />EvereM WA 98201 <br />l Phone:259�8810 <br />. . _..____. . . <br />INITIAL INi�ECTI�w <br />KIRK BROOKB <br />D�T6 � /�-92 <br />W <br />H <br />� <br />� <br />� <br />O <br />� <br />� <br />O <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/appllcent hereby agrees to hold and save harm- <br />less the City ot Everett irom any and all claims tor demages, eosts, <br />expenses, or causes ot ection thet may arise because of instellalion <br />and maintenance of the improvement or other rlght•ef•wey use hereto <br />applied for and further agree9 to remove same upon notice from the <br />City and to replaee public propeAy dameged thereby. <br />Signature of AOPlicant Date <br />WORK AUTHOFi12ED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTIY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. ' <br />