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-- - -- � .-. <br /> � Pueiic Wo�ws Permil• <br /> Date <br /> � emy.oea�.• <br /> Application For __ <br /> PUBLIC WORKS PERMIT PeTota�eeFea 5 <br /> Less400i FeePa�a 5 <br /> 9a�ance Due $ <br /> Print or Type Only plan Check No: H 48718 SEPA <br /> Appllcat.Date: 06/26/95 <br /> Job Addreee: 80i0 k GLEN DR <br /> Owner: NELL CARL <br /> Tenant: <br /> Propoeed Uee: GARAGE/SFR <br /> Deac. oL Work: :;o Phone <br /> Owner NEW ATTACHED GARAGE <br /> OFFICE SET JOB SET :iP — Phone <br /> Applicant <br /> APPAOVED FOR PERMIT: DATE_/_/_ BY <br /> Describe Proposed Work _ <br /> .._._.___.------ � <br /> Project Address(if known! � � <br /> � <br /> Attach four(4) copies of Plans br proposed wurK � Draw, to scal�� ani ncle the'o�luwmg as appficabie: � <br /> • Property Lines • Centerline ot 5treet <br /> • Outline anA dimensions of all exisGng and • Indicale Norih <br /> proposed structures on the lol • Show any rroaosed grading changes <br /> � Existing and proposed utilities • Show measurements /� <br /> W <br /> DO NOT WRITE BEIOW Trt�S LINE O <br /> PERMIT CONDITIONS � <br /> 1.All calls for inspection shall be made 24 hrs.in advance-phone 259•881 O. <br /> 2.All work shall be pertormed in accordance with this permil and current CiIY of Everelt Design and Construclio� <br /> Standerds and Specilications. � <br /> 3.Call location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1•800-424'S555. <br /> O <br /> P1JdLIC WORKS PER�I�• � <br /> I�iO RE�UIRfcn ♦A <br /> ♦/♦ <br /> �Y OeATE_ G zG,�s' . <br /> a <br /> ACKNOW�EDGEMENT OF CONDITIONS <br /> The undersiqned owner/applicznt hr.reby agrees to hold and save harm• <br /> --�--� less the Cdy ol Everett Irom any and all claims lor damages. costs. <br /> � exPenses. or causes of action thal may arise because of i�stallation <br /> �� anA �na�ntenance n! the improvement or other righl•ol•way use hereto <br /> I apphoc: lor and �uriher agrees to remove same upon notice irom the <br /> Approved tor Construction �a��' � Gty and to replaca P�blic properiY damaged lhereby. <br /> i <br /> fINAL INSPECTION Date � Date <br /> I Signalure ol Applican! <br /> ApprovedasConstructed WORK AUiHOR12ED BY THIS PERMIT MUST BE STARTED 'NITHIN <br /> PUBLI.^.WORKSDEPARTAIENT 180 DAYS OF DATE ?E�7MIT �S ISSUED AND THEREAFTER IS TO <br /> ����3200CedarStreet 8E DILIGENTLY PURSI'eD TO COMPLETION. 7HIS PEFMIT MAY BE <br /> 7 rr Everelt.WA 98201 I CANCEILED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> ��s� Phone:259�8810 PROJECT OVER 90 DAYS DUFATION. <br /> � -- ---�� ---------- <br />