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Date 9�23/85 <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Laszlo Patolskai 6102 Dexter <br />Pu�lic Works Pormit ♦ __ <br />eieq.�eo�.+ 85/15465 <br />PUEtIc Wo�ks Fee 5 <br />Taiel Fee <br />Ln.s ApO� fea Paid $ <br />Balence Ddo $ <br />Everett 98203 353-6524 <br />Owner Mailinp Address City Zip Phone <br />Same <br />Applicant Mailing Address City Zip Phone <br />Garage with craft room and wood shop <br />Dea�ribe Proposad Work <br />Prolect Address (if known) <br />Attach lour (4) copies of plans for proposed work - Draw to scale and note ihe following as applicable: <br />• Property Lines • Centerline of street <br />• Outline and dimensions of all existing and • Indicate Norih <br />proposed structures on the lot • Show any proposed grading changes <br />• Existing and proposed ulilities • Show measurements <br />PERMIT CONDITIONS <br />1. All calls for inspection sliall be made 24 hrs. in advance - phone 259•881 5. <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and Construction <br />Standards and Specilications. <br />3. Call Location U�derground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-500•424•5555. <br />��L�c_��v �' /�/irl !-rs� �,��=�T�.�c.� <br />�.�����-��QY , .cJ� P�i.s'�,G ��o,�s_ <br />,L�F.ei�?i� �E4l�i,�F'.G�: <br />� <br />'- , , ��> �'03.�- , <br />/ Q � /�s <br />� <br />Approved for Construction Date <br />FINAL INSPECTION Date / <br />Approved as Constructed �� <br />everett PUBLIC WORKS DEPAFTMENT <br />� 3200 Cedar Street <br />Everett, WA 98201 <br />Phone:259-8815 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />� <br />� <br />� <br />� <br />� <br />a <br />The unde�signed owneUapplicant hereby a�rees to hold and save harm- <br />less ihe City ol EvereU irom any and a0 claims for damages, cosls, <br />expenses, or causes of action lhat may arise because ol insiallation <br />and maintenance of the improvement or other right-oFway use hereto <br />applied for and furlher agrees to remove same upon notice Irom ihe <br />Ciry and to replace publ' roperty dam ged there�. <br />f� <br />Applicant <br />uate <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE OILIGENTLY PUFSUED (O COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON TH�S <br />PROJECT OVER 90 DAYS DURATION. <br />z <br />0 <br />� <br />c�'� <br />m <br />� � <br />� � <br />�+ —� <br />�n x <br />m <br />v <br />m� <br />om <br />-� z <br />m� <br />.. <br />p 2 <br />� _ <br />.. .. <br />� N <br />T <br />O � <br />�1 3 <br />-i m <br />x <br />m �. <br />N <br />U <br />or <br />nm <br />c in <br />3 � <br />m <br />z c� <br />�m <br />a <br />� <br />� <br />_ <br />n <br />Z <br />-� <br />� <br />N <br />Z <br />O <br />� <br />� <br />m <br />