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� �P'ication For <br /> PUBLIC WORKS PERMIT D81e 5-11-98 <br /> PUBLJC WORKS DEPARTMENT Public Nbrks Pertnft M ���Z� <br /> 3200 Cedar Street � 1 '� �Q <br /> Everetl,�82p1n�7'�0 <br /> r�� �����, Building Pertnit N 58777 <br /> TYPE OR PRINT ONLY Public Works Fee S � <br /> _ Carl Edminster Const 19015 Firlanda Way N Seattle 98133 206 546 9251 <br /> Owner Mailing Address City Zip Phone <br /> _ Owner <br /> Applicant Mailing Address City Zip phone <br /> Describe Proposed Work new houae ■ , ■ <br /> W <br /> � <br /> � <br /> PROJECT ADDRESS(if known) ��4 �)r� Lot 3 SP 6-96 � <br /> Anach four(4)copies of plans for proposed work-Draw to scale and note the following if applicable: � <br /> •Property Lines 'Outline and dimensions of all existing and proposed structures on the lot •Existing and proposed utilkies O <br /> •Centerline of street •Ind(cate North �Show any proposed grading changes •Show measurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS: � <br /> 1.All calls for i�spection shall be made 24 hours in advance- phone 259-8810. O <br /> 2.All work shall be performed in accordance with this permit and current City of Everett Design and <br /> Construction Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMl3ER 1-800-424-5555. � <br /> 4. �oof�v� rLn o�=F �O sf�...�d.��k�,c s�� �,n��;de� o� lot, � <br /> S, ,d,dV�a,rc �v a�tEz,�i� 5�,�.� I lv+- c�.�-��+�,.-F ��,�rds.. Q <br /> 0`-�?-9A �:GYF�! a <br /> A 58777 <br /> BUiLD 1060.63 <br /> FLUPfE 9:.C:1 <br /> MECI; BO.DG <br /> SRi.i�"v 4.Su <br /> :'^nTVE ^cO.00 <br /> � 31542 <br /> SE4;[R 70.00 <br /> UiTLI]l" jb13.00 <br /> �� �piA,_ 2439.13 _ „ <br /> �-8-s��' _9:;v,i.o <br /> ACKNOWLEDGEM��ST��F GONDITIONS <br /> /,� /� � _ ` J I� � The undersigned ownedapplicaM hereby agrees to hold and save harmless <br /> �C� (CJL j the City of Everett trom any and all claims for damages,costs,expenses,or <br /> ApproTe�for Cya�ction i� Date causes of action that may arise because of InsWllation and maintenance o( <br /> C the impmvement or other right-of-way use hereto applied fw and lurther agrees <br /> � ^� to remove same upon notice from the City and to replace public property <br /> ��-��_ ��._/�-J�Q damaged thereby. <br /> FINAL INSPECTION Date <br /> Approved as ConsWcted L\ ' <br /> � �1_`�-� S�7�� <br /> Signature of Applicant `—T�ate <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS TO BE DIIIGENTLY PURSUED TO <br /> COMPLEfION.THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PRQIECT OVER 90 DAYS DURATION. <br />