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�..;�„ <br /> �� <br /> f, :... <br /> --� . <br /> Date 10-IS-92 �_ �"' lzc� '7 Publ.clYorksPermit� �Z / <br /> BICp.0ep1.• 38381 <br /> AppliGation For <br /> PUBLIC WORKS PERMIT '°°'�°w°"=F`° g <br /> H .o�a�Feo <br /> x��Q Lws POoi.Fco Pai� S <br /> �s� � <br /> ��� Baloncc Duc $ <br /> ��� PrintorTypeOnly �� ��������_�-Z"`��_� <br /> H 9� <br /> y 7 H C.W. Bright PO Box 1356 Snohomish 98291 485-1319 <br /> O R.'O Owner Mailing Addre55 City Zip Phone <br /> �i.+ H'i1 <br /> y~ OWneT <br /> � 7p"� f.pplicant Mailing Address City 2ip � Phone <br /> HC <br /> � �p �escribe Proposed wark new house <br /> �j]Y (7 <br /> zy� <br /> x Wt7 Ui y _ <br /> nC., d y Project Address(it known) 4709 Foiest Dc � <br /> [s] �Cr+l Attach four 141 copi=s of plans for proposed work� Draw lo scale and note the lollowing as applicabla � <br /> H O N • Properiy Lines • Centerline ol street ♦A <br /> • Outline and dimensions of all existing antl • Indicate North V� <br /> � �� proposed slructures on the lot • Show any proposetl grading changes <br /> • Existing and proposed utilfties • Show measmements M <br /> W <br /> DO NOT WRITE BELOW THIS LINE O � <br /> pERM1T CONDITIONS <br /> 1.All calls for inspection shall be matle 24 hrs.in advance�phone 259-8810. � <br /> �'e► 2.All work shall be pedormed in accordance with this permil ano current City ot Everett Desiqn and Constmction <br /> !� Slantlards anA Specilir.ations. , <br /> 3.Call Location Underground Servic�4&hrs.before you dig.TOLL FREE NUMBER 1�800•424-5555. � <br /> f` O <br /> a�' <br /> �— ■ w <br /> _I <br /> i� � o <br /> �,� <br /> a <br /> ��e <br /> �; ACKNOWLFDGEMENT OF CONDITIONS <br /> �' � �� _ The undersigneJ owner/applicant hmeUy agrees to hold and save harm� <br /> less the Cin� of Ev�rett irom any and all claims lor damages, cosis, <br /> � / expenses, oi cause�,. of action that may arise because of installation <br /> �" v ;�nd maintenance of the improvemenl or other ric�hPol�way use herelo <br /> � � i � ���S��Z apP�ied for and lurlher agrees to remove same upon notice irom ihe <br /> Approved for Con ruction � Date City and to r p ic property damaged thereby. <br /> /r� � �� /7 " �.3 I `I �J <br /> FINAL INSPECTION ���2 Date <br /> Approved as Conslructed Siynature ol Applicant <br /> � �VORK AUTHORIZED BY THIS PERMIT MUST BE ST�ARTED WIiHIN <br /> PUBLIC WORKS DEPARTMENT 1B0 DAYS OF OATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> ,v� 3200 Cedar Street BE DILIGENTLY PURSU[D TO CO�dPLETION.THIS PERMIT titAY BE <br /> Everett,WA 98201 CANCELL[D BY THE CITV UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259��e10 PROJE(;l OVER 90 DAYS DUHATION. <br />