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/ <br /> /�: n�iST�k,[ Pu01¢WorbPmmil� �� ��1- <br /> Date 10/27/92 /" � m��eoso� . 38488 <br /> Apalication For 7 - 1 �'� , <br /> PUBLIC WORKS PERMIT FuohcWo�xaFee 5 <br /> TomlFaa <br /> tessAnul G+eCeitl $ - <br /> � �� p.�lanco0u. S �lf �—• <br /> p y � Print or Type Only <br /> �f <br /> t" y y — <br /> M � � Blce Bay Inc 5307 139th Ave SE Snohomish 98290 568-9342 pnone <br /> � � Mailing hddress �'�Y Z'P � <br /> Ow�er <br /> '� <br /> � y � Duane Brandvold 568-934:' <br /> �-I City Zip Phone <br /> y t+ ApPlicant Mailin9 Address <br /> � H C New ho:.se — --' <br /> O H Describe Proposed Work - <br /> �^ � g <br /> y/V � <br /> � y � W <br /> H toe 2. SP 13-9Z_ � <br /> cn 4823 Glenwood <br /> p.� Project Address 01 known) <br /> �� y �� <br /> � A�lach lour(41 copies o' P���s lor proposed work-Dr.:•i:c scale and note the lo!lowing as appllcable. � <br /> • property L�r.es • Center�ine��street <br /> H � • Outline end dimensions oi all e:c ;ti��g :md • Indicate Norih <br /> � proposed slrucWres on Ue lot • Shrnv any propo5ed gradin9 chaog�s <br /> • Show measurements /� <br /> • Existii�,�a�d proPosad utihli�> W <br /> DO NOT WRIT[OEL01V THIS LI�lE O <br /> s <br /> � PERMITCO�JDITIONS � <br /> 1.All calls br inspeclion shall be made 24 hrs.in advance-Phone 259•887 0. <br /> C� 2 All wak shall be peAormed in accordance with lhis permil and currenl Cily of Everell Design and Consiruction <br /> Stand.�rds and Specilica�ions. � <br /> 3.Can Locstioo Underground Sorvice 48 hrs.hetore you dig.TOLL FREE NUMBER 1-800•424•5555. <br /> � � �, �o Avo�r� Des��C�i�i<i�G ��E .s�p.scvaEs r45Y%��.�arc� O <br /> i �`I wr t�rr TIdEc��x, .d-u- ��vnisix�u�, FOOT�N� tiNO�OK. yA�LJ <br /> ��tiivs Th�Tc.�NivcT �3� v,R�c,—ED TU7� sT�Ef'M�T � <br /> r� T�UNTLINEU � jliE �-r-TGi•1 0F "T1IE:�rEE-P 5�-�=�cS � <br /> i �� O <br /> ,_�_ a <br /> i <br /> ��v��y ACKNOWLEDG[MENT OP CONDITIONS <br /> ��re -�� 1he undeisi9netl ownevapPlicanl hereby agrees lo hold and save harm� <br /> less Ihe Cl�y ol Evorett from any and all claims for damages. cosls, <br /> /� expenses. or causes ol action Ihat may arise bec.dse o( inslallalion <br /> �I/I�1� f /�p �C�7 and malntenance o� ihe improvemenl or other righ:�obway use herelo <br /> ��!f1 1/n,'^, C f i ��� I �'—1 �✓ apPlicd lor and turther a9rees to remove same upon nolice Irom ihe <br /> --N�—�� Date ",i and to replace pubhc nroperty dama{7ed Ihereby. <br /> ApnroJ�d lor Constryclion � <br /> / � .� . ,Lc1! , � � <br /> � '�� _ , S- w- i3 , ��. ,. � <br /> i°INAL WSPECTION Date � D te <br /> ignaNre ol Apphcanl <br /> Npproved 2s Co�slrucled WORK AUTHORIZED BY THIS PERMIT A�UST BE STARTED WITHIN <br /> ,��� PUBLICWORKSDEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEqEAFTER IS TO <br /> � 3200CedarStreet BE DILIGENTLY PURSUED TO COMf'LETION.THIS PERMIT MAY BE <br /> � F.vcrcll,WN9B20� CANGELLED BY THE CITY UPON ANY STOPPAGE OF\NORK ON 7HIS <br /> Phone�,259�BB10 PROJECT OVER 90 DAYS DUFATION. <br />