Laserfiche WebLink
� <br />� <br />TYPE OR PRINT ONLY <br />. <br />Application For � <br />PUBUC WORKS PERMIT Date 5-20-96 <br />PUBLIC WORKS DEPARTMENT Public Warks Pertnit R �`�' �� <br />320� Cedar Sireel <br />Everett, WA98201 259•8819 ��%/,, Building Permit N_ 51774 <br />L' <br />t P � °,� ��' � � Public Works Fee $ � <br />Loren Dorrah 28205 Lincoln Way Lynnwood 96036 787-6700 <br />Owner Mailing Address City Zip Phone <br />Curt Johnson 337-4733 <br />Applicant Mailing Address City Zip <br />Describe Proposed Work <br />new duulex <br />PROJECT ADDRESS (if known) <br />208 Dorn Ave <br />Lot 2 SP <br />Atiach four (4) copies of plans tor proposed work - Draw to scale and note tt:a following it applicable: �� <br />•Property Lines 'Outline and dimensions of all existing and proposed struccures on the lot •Existing and p��u'i8i(ies „O � <br />GLW Sll <br />•:,enterline of street •Indicate North •Show any proposed gratling changes •Show measurements �� s154.� <br />.,v�.....� ..�����.,��.... �.....�.'— <br />PERMITCONDITIONS: ��' ��c� <br />1. All calls for inspection snall be made 24 hours in advance - phone 259-8810. �� 5�0. W <br />2. All work shall be performed in accordance with this permit �nd current City of ��i9� � <br />Construction Standards and Specifications. � <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUM ���- s70.00 <br />� :��4.� <br />BNDIII 5725.00 <br />CHECK �4f350.00 <br />!. Sidc sewer mid Storni s�wcr conne.tious shall bc installvd as per We �y�proved <br />conshvction pl�ui for tlie short plat impro��ements. <br />W <br />� <br />�'A <br />V♦ <br />�k'k <br />O <br />� <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harmless <br />the City of Everett from any and all claims for damages, costs, expenses, or <br />causes of action that may anse because of installation and maintenance of <br />the improvement or other right-of-way use hereto applied for and further agrees <br />to remove same upon r�otice from the City and to replace public property <br />damaged thereby. <br />/� 30 ���� <br />Sig ature of IicaM �� �ate <br />WORK AUTHORIZEO BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS I UED AND 1}iEREP.FfER IS TO BE DILIGENTLY PURSUED TO <br />COMPLEfION. THIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />