Laserfiche WebLink
Date 9-5-91 PubhcWotksPormit• �� � �`1 �`1 � <br /> Application Fpr oiaa o�o�.• 91/27649 <br /> PUBLIC WORKS PERMIT Pu`TotlFecFeo g — <br /> Less Rppl.Fea Paid 5 <br /> .. -. .-� : ❑atancc Oun S -�� <br /> Print or Type Only �, � <br /> ,.� . <br /> � . � � - rii" � . ; iu� <br /> n . �:� <br /> . � � ., � :a ' �- <br /> Rod Nicholas 16000 Mill Creek IIlvd #110 Mill Creek 98012 337-G611 <br /> Owner Mailin�A,ddr�Ss � - � , City �,, �� -; , Zip Phone <br /> . -� i � � io r� :_ _ _i 'r:. <br /> �I :i � . -'i � L] .� ci) _: i .i <br /> i . i <br /> : : ,.., ' i 'i : ' . '. i <br /> i-i , _ , � . � �'�� _I ._i LI _J {.: .J.. <br /> Curt Johnson • � � � �. . ,:'� ', '' 337-9733 <br /> Applicant Mailing Address City 2ip Phene <br /> Describe Proposed Work new construction du lex ��Q [�2�� <br /> , <br /> ��� W <br /> Project Address(it known) � Z ���\ V � <br /> Attach�our�4)copies of plans for proposed work- Draw to scale and note the following as applicable: � <br /> • Property Lines • Centerline oi street � <br /> • Outline and dimensions of all existing and • Indicate Norih <br /> proposed Siructures on the lot • Show any proposed grading changes <br /> • Existing and propoSeA utilitie5 • Show measuremeNs � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS O <br /> 1.All calls for inspection shall be made 24 hrs.in advance•phone 259-8810. � <br /> 2.All work shall be performed in accordance with this permit and current City ol Everett Design and Construction <br /> Standards and Specifications. <br /> 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1-800•424-5555. � <br /> � � �� �l� � � � � � c�l( ✓ool�'�� �o ct.,d G�.- �v-e.w�3�, c��''q,�t'��C ��-� O <br /> � , �� t !� 1,�.�k �1�.�, <br /> ' s <br /> �s ' �-i�� ,�.t si� , T����� � � <br /> H <br /> � <br /> � <br /> a <br />` '� �CKNOWLEDGEMENT OF CONDITIONS <br /> L�e undersigned owner/applicant hereby agrees to hold and save harnr <br /> less the City ol Everett irom any and all claims for damages. costs. <br /> expenses, or causes of aclion ihat may arise because ol inslallation <br /> /\1� �L/�p S��� Q. 9i and maintenaP e ol the improvement or other right-ol-way use hereto <br /> l.l--^-� ` - - — 1 �� applied Iotyzfid�further ac�rees to remove same upon nolice Irom the <br /> pproved for Consiruction Date City andid r lace public property damaged thereby. <br /> 1� / P� ,/ , I <br /> /\//�,� =C� � /� �� -� L —�j'L :%"� i// /i� /. <br /> j/ . i ) � ����� /��� <br /> NAL INSPECTION Da�e : ��-�/'� � - � i <br />. ,. ,.. .' os Construded ' Srpn�f�e ot App icant / / Date <br />�'�' PUBLICWORKSDEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />�i_� ' 780 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200 Cedar Slreet <br />� Everelt,WA98201 BE DIUGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone�. 259�B�t0 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJEGT OVER 90 DAYS DURATION. <br />