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Date 9 g 95 <br />qpplication For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />TO POSTING fz-''�- 5 <br />Loren Dorrah <br />2820 Lincoln Wy Ste B <br />Describe Proposed Work <br />M3��Ing �+uuico= <br />, <br />PuElic Wo�ks Pe�mit + ._� ��___�/, <br />9ien. Oeo�� • <br />puph<Wo�ksFee S <br />Total Fee <br />Less / Uul. Fce Paia $ <br />a 7AJ <br />Bala�ce Don <br />98046 787-6700 <br />Msihnq Atltlress � � <br />New house - Basic 1114 <br />6626 Fleming St <br />r�n <br />rmm�: <br />Phone <br />Project Address lit knowN - <br />_ � <br />Atlach four (4) copies ot plans tor proPosed work - Drav: to scaie antl no1e.� C�°�`erline of st ee� ablP: y 1'=.1-' <br />� Property Lines • Indiwte Narth ��� � '�� -.�� � <br />• Ou�line and dimensions of all existing anA � cnow any preposed 9ratling changr.s <br />proposed StruCWreS on Ihe lOt �$how measurements -_-- '•-- <br />• Ezisting and proposed utilities r �^�`"1 <br />uv rvv i vvni � � o��.... ....- ---'- � , . <br />_�_ ....__'.��„` <br />PERMITCONDITIONS -'-" '":'�..:;' �--_ <br />1. All calls for inspection shall be made 24 hrs. in advance • phone 259•881 U• - <br />2. All work shall be performed in accordance with this permit and current City of Everett DeeigA^antl Oonstiucilon,r <br />Standards and Specificetions. 555 :�, _ ;;�� <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREk3 NUMBER 1 800-4�`!��5 _ <br />4 Yrovide 8 oEf atreet parking stalls [or the duplex. ,r ��; ,_ .•. <br />S1'60cV b1�'f � -'''� <br />i. k�oi-top runc+[E shall be direcced to the in6ltration system provide�i on rhe lol _, . r, ,_,_ <br />�A�PUBLIC WORKS �EPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />Phone: 259-BB70 <br />W <br />H <br />� <br />� <br />� <br />O <br />� <br />� <br />O <br />a <br />ACKNOWLEDG[MENT OF CONDITIONS <br />The under�!9ned owner/applicant hereby agrees to hold and save harm� <br />—� less the Cdy of EvereU Irom any and all claims tor damages. costs. <br />� ezpenses. or causes of action that may arise because ol installation <br />��ii�1 m, intenance of lhe improvement or o�her righPol-way use here�o <br />Iappliec! lor and furihe� agrees to remove same upon notice (rom ihe <br />� C,;y .v:d to rePlaca V��bhc ProperiY damaged thereby. <br />' a� <br />i '� Da e <br />Sion t re o1 APPlicant <br />y�r0 AUTIiORIZED BY THIS PE I MUST BE STARTED W�THIN <br />�80 DAYS OF DATE PERMITIS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />PROJECT OVER 90 DAYS DURATION. STOPPAGE OF WORK ON THIS <br />