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.---- - - _ ..�.- ------ - ----- <br /> . . -. . _ _- _ ... �,- t <br /> ,,�;�, F- l- i�--`- _i ��� i <br /> �8"B 9-5-91 � , pu�iicN;�eePermltr _�32— <br /> Applicetlon F,or <br /> eiaa.oeo�.s 91/27650 <br /> � PUBLIC WORK�S PERMI�O POSTING - P cWorksFee s <br /> �o��l Fea <br /> � LBas:.pOL Fee PaiE s `) <br /> `�'.� � �'J o :� c u t!i tl ['J eaiaoca ooe S Z" • <br /> Print or Type Only "- . <br /> 0470� ��ion � o <br /> . � � K� N d -Y :? C'J M Cv C�l <br /> . � �n I� �• f. � r< M C� <br /> �. ..: .s� aq . w w <br /> Rod Nicholaa 16000 Mill G7�c B�vd fl110�� Mill Crea"ic 98012 337-6611 <br /> Owner MeiNng y���y,,; c�a {� ' �.' �� City (� Zip Fhone <br /> -� Yt41G71J " ...+ 0 •'-7 t'� 26' � �] <br /> (y 1— J30P ppO fDU�.JUS [c W <br /> p � .-Sa tCij �J ~ =L 1 c"'�i � N U �� <br /> C+rt' Jehneon 337-4733 <br /> Applicant Mailing Address City Zip Phnne <br /> Describe Proposed Work riC•a construation duplex <br /> ��� �> . / ,, LLI <br /> Prolect Address(if known) r���� � L'� � e' 1\VCc:L �^UE::��!l. /�� � � � <br /> Attach four(4) copies of plens lor proposed work- Draw to scale and note the following as applicable: � <br /> • Property Lines • Centerline of street � <br /> ' • Outllne and dimonsions of all ezisting and • Indicate North <br /> proposed struclures on the lol • Show any proposed grading changes <br /> • fxistlng and proposed utilities • Show measurements /M <br /> W <br /> DO NOT WFITE BELOW THIS�LINE O <br /> PERMIT CONDITIONS <br /> 1.All calls tor inspection shell be mede 24 hrs.in advance•phone 259•8810. � <br /> 2.All work shell ba periormed in accordance with this permit and cunent City of Everett Design and Consiruction <br /> i Standardsand:'pecifications � <br /> 3.Cell Location Ui:derground Service 48 hra betore you dig.TOLL FREE NUMBER 1•800�424•5555. � <br /> � / � <br /> � � '� Jti\ �, 1 ; nC .� II NOi �-J}� �•\� c�r- , JC\VJ�,}_ �� � �� �:; '}C O <br /> i.: " _L���, =; (��.,, � �� ,�� de�� I...,, . 11���1- ��r.�-�, <br /> � <br /> � I <br /> � <br /> . a <br /> ACKNOWLEDGEMENT OF CONDITIQNS <br /> �-�' The undersigned owner/applicant hereby 2grees to hold and save harm- <br /> less the Cily of Everett from any and ali claims lor damages, costs, <br /> � expenses, or causes of action that may arise because of installation <br /> ���) ('� � _� and maintenance ot the improvement or other right-ohway use hereto <br /> r-i , y:.. ��(�k.-G.Q� �i� � �c�' '�� applied for and turther agrees to remove same upon notice Irom the <br /> Approved for Construction Date Cily and tr replace public property damaged thereby. <br /> FINAL INSFECTION Date -, . ' �"� Date <br /> Approved as Constructed Sign..ture oi Applicant <br /> � WORK AUTHORIZED 9Y THIS PERMIT MUST BE STARTED WITHIN <br /> PUBLIC WORKS DEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200 Cedar Street BE DILIGENTLY PURSUED TO COMPLETION. THIS PEP.MIT MAY BE <br /> �T Everett,WA 9B201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON Th11S <br /> �. Phone:259•8010 I PROJECT OVER 90 DAYS DURATIOtJ. <br />