Laserfiche WebLink
Date 2-z3-94 u PubLc WO�kS Permit• q�/oy3 "f <br /> � APP���a��o� F�, TO POSTING S -z.s -9r a�da oeP, . 43�� <br /> PUBLIC WORK� PERMIT PuoTolalFeeFee s <br /> r�j less Aoo�Fec Paia S <br /> Q �� r' <br /> O Balanca Due S — <br /> Print or Type Only � g n o c� in g o r� �, o <br /> a ,ovioo � oa� or�it� <br /> � � � � � � vi '� a mm <br /> .: w w a. r+ <br /> Ramon Rekdahl 5717 SSth St"SW mMukilteo 98275 �353-9�90 <br /> Mai4in A r2c3'? = a N Zip Phone <br /> Owner 9 � � r� ��ca � � <br /> �a o �� c� xc� � � o �`iJ -+ �� <br /> .. ono �� orn � -- o � Nw <br /> � o � J W J o-• � o w .�+ x <br /> Owner in :scaasmmoasu� .+ c� <br /> Applicant Mailing Address City Zip Phone <br /> Describe Proposed Work new house <br /> Lot 2 SP 1140-91 ' <br /> W <br /> Prolect Address�if known� 4823 Gardner Ave ✓ � <br /> Attach four(4) copies ot pians for proposed work• Oraw to scale antl note ihe following as apPlicable: � <br /> � Property Lines • Centerline of street � <br /> • Outline and dimensions of all existing and • Indicate North <br /> proposed structures on the lot • Show any proposed grading changes <br /> • Existing and preposed ulilities • Show measurements M <br /> W <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1.All calls tor inspection shall be made 24 hrs.in advance-phone 259•8810. � <br /> 2.Atl work shall be performed in accordance wi'h this permit and current City of Everett Design and Canstruction <br /> Standards and Specifications. <br /> 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1•800-424-5555. � <br /> �'• 'Pmv�de 4 0�' strcct -pz�rk�n� s�� Is — �� ^'�us� �e. O <br /> m 1+1�n�vrv! ZO� G I�f -�i'-owi -FzGG o-F�✓�tc�. doo�-s -Fo <br /> ��,r' a�_ rsf �ccess e�s�n�e.r�,. N <br /> � <br /> � <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> ��� The undersigned owner/applicant hereby a9rees to hold and save harm• <br /> less the City of Everett from any and all claims ior damages, costs, <br /> '��/ ezpenses, or causes of aclion that may arise because of instaltation <br /> n /y/L 2 and maintenance of the improvement or other righPol•way use hereto <br /> ,�t X A�/ � JV 3��� applied for and further agrees to remove same upon notice from the <br /> Ap roved for Construction ���e City and to replace public pr a aged thereby. <br /> ���/���-�.zf-SS ��.r� ��� ' S-/'6—�'S <br /> FINAL INSP2 I Date <br /> Approved as Constructed Signature ol Applicant Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED W�THIN <br /> PUBLIC WORKS DEPARTMENT 1B0 DAYS OF DATE PERM!T IS ISSUED AND THEREAFTER IS TO <br /> 3200CedarStreet BE DILIGENTLY PURSUED T�) COMPLETION. THIS PERMIT MAY BE <br /> Everett,WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE Of WORK ON THIS <br /> Phone:259•8870 PROJECT OVER 90 DAYS DURATION. <br />