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` � � i <br /> � A°Nirauoo For 2-2-9 B <br /> PUBLIC WORKS PERMIT °et° <br /> PUBUC WORKS DEPARTMENT PuMic Works Pertnit X _=1v ZI <br /> 3'L00 Cedar St�eet <br /> Everetl,WA98201 2ss-seio � 3 1998 Bui�dingPertnNN 57790 <br /> ' POSTING DE�— <br /> TYPE OR PfiINT ONLY Public Warks Fie E.��� � � <br /> Kvernmo Construction 16212 Bothell Hwy SE MiJ.l Creek 980I:�_ _, �.c,5--'E911 <br /> Owner Mailing Address City 'Lip � i+h�onH <br /> Owner <br /> Applicant Mailing Address City ZiP Ph°^e <br /> Describe Proposed Work new house — Basic 1264 � <br /> "� , . � I <br /> N SB121 a <br /> , .^ 9J12� � <br /> PROJECT ADDRESS(if known) 4309 Crescent Ave Lot 5 �P Y.31-96 ,. � <br /> Attach four(4)copies ol plans for proposed work-Draw to scale and note the following if app!kable: TO�I�Ft C0.00 O, <br /> •Property L(nes 'Outline and dimensions oi al�exisling and proposed structures on the bt •Existing and proposed utiltties CF-��Fi <br /> 'Centerline of street •Indicate North 5how any proposed greding changes 'Show measurements A Oh15891 � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS: Z <br /> 1. All calis for?;ispection shall be made 24 hours in advance-phone 259-8810. O <br /> 2.All work shall be performad in accordance with tFiis permit and current City of Everett Design and <br /> Construction Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-SS66. � <br /> �{� 'rh:� fiGrv..`� �s .�r' s;�a wa-K /�i,t; ( � �os oh I� — 1Jb &.t idcv� � <br /> �v�',.+�� -�.,r--�h;r si��. �..,�Il bc �55�ed c9n�Sl �^� o�� �5 O <br /> ,,-�cc,�cc� �w�,t -�r-� �.,,v�c� -F�►^c ky �.a.�+, a <br /> �7� �+�� 4row�d ww{� $�'1G�� bt �d15�CG�'C� Eo �I�.0 ST..'�J'i5{4c�`al <br /> 1 <br /> a-F -�I�-e. C�eo�ech ��5;„e.�{-,,.� 4�. w►��s� d�s t g►•d'C�-e <br /> p�:�.c.u..,�,..�. <br /> ACKNOWLEDGEMEN�OFCONDITIONS <br /> � �� The undersigned owner/applicant hereby agrees to hoid and mve hartnless <br /> �/ the Cfry of Evereri from any and all claims for drnepes,costa,expenses,or <br /> Ap oved f o ction� Dal — �uses of eclb�thet may arise because ot InsteNatbn and maintenance of <br /> Me improvernent or other right-of•way use hereto appFed for mW fixtl�er agrees <br /> ' to remove same upon notice from the City and to replace pubNc proparty <br /> % /� ./- dam thereby <br /> FINAL INSPECTION ' D�te <br /> Approved as Constructed <br /> ignature of Applkant � <br /> WORK AUTHORIZED BY THIS PERMR MUST BE STARTED WITHIN 1B0 DAYS OF DATE PERMR IS ISSUED AND THEREAFIER IS TO BE DILIGENRV PURSUED TO <br /> COMPLETION.THIS PERMIT MAY BE CAIJCELLED BY THE CIN UPON ANY STOPPAGE OF WORK ON'(HIS PRQIECT OVER 90 DAYS IX1RAT10N. <br />