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- : � P�StING � � "__- 5 =��-- <br />Date 4-26-95 <br />Appiiwtion For '-' <br />.n <br />PUBLIC WORKS PERMIT � <br />Print or Type Only <br />Griff <br />1 <br />4Cd!BSS <br />PuOL[ Y/orAS Pormil • �� � �^Y � <br />[iian Deo�� • 48184 _ . <br />P„„��� ��a,ks F�� 5 <br />TMaI �er <br />L055 A04�I fnrv Pp�.i� S <br />... r_�,-�oc� <br />:�_ �nvic:�c.i _ <br />n: ' r' Y o G 'rn <br />i� o�' ++> r�i N r � <br />.—i er " C.�. <br />_.� � <br />�_' m__' _ _' �'i <br />Lindsay Moving Mike Martin 712-9700_ _;`� <br />qpplicant M.,ain:; AdAress � <br />Describe ProPosed Work relocate house oII same lOt <br />Project Address UI known� 232 Dorn AVe ____ __.___ —_ <br />r.�� S.�O�� <br />U: t i iT? Phonr, <br />L'J Sj ���`.t ' <br />iAf��-'.7_ f7 .� Iil <br />� iY. A:' J C� i.�,l � <br />u [n i '� n_ .... <br />- ._� _...__ — Phon� <br />A�tach tour (4) eoP�es ot Plans fo� ProPoseJ worn � D�av: ta ,c,i�....i:,.i coi..r th�•'Wlu�vin9 ie: aoPhcatil,r <br />• Property Lines • Cenl�t�line cl sireet <br />• OuUine and dimensions ol all exisLnc anA • i�•.�:icaL: North <br />. PrOPOsed struClureS on �he lat • cnr��.: rny nroposed yradinn r.hanq��s <br />• Ezisting and proposed utilities • Sh�m� m��asurements <br />iH15 <br />PERMIT CONDITIONS <br />1. All calls (or inspection shall be made 24 hrs. in advance - phone 259-8810. <br />2. All work shall be peAormed in accordance with this permit and current City of Everett Design and Construction <br />Slandards and Specifications. <br />3. Call Loration Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800•424-5555. <br />r ��� �/ <br />I� ,Q <br />� � ��a � <br />�� � <br />��-�r�l,f _ <br />Approvea as �onsuuc�uu <br />��r�e� PUBLIC WORKS DEPARTMENT <br />3200 Cedar S�reet <br />Everelt, WA 98207 <br />Phone:259�8810 <br />OS/17/45 ii�.'.6Ai1 i <br />/ <br />N00043164 <br />E:LDG 5108.Q0 <br />PIEG 37.G0 <br />SRCHRG y4.50 <br />QRIVWV 3�0.00 <br />FLN CH 570.�Q <br />a000.o�� <br />SEWER 370.00 <br />CHECt; s279.70 <br />z <br />o� <br />� <br />� <br />O <br />a <br />ACKNOWLEDGGMENT OF CONDITIONS <br />7 he und?r.��aned ownevapplicant hereby agrees to liold and save harm- <br />�ess ;�ie Cdy ot `r_veretl Irom any antl .II daims for (IBfill(jCS. CO5�5. <br />pvpensF:; or causes 1 action that may anse hecause of installation <br />and maint�nance nl r nnprovement or other righPof-way use herelo <br />�ppi�ed tci a •�r' �� �9rees to remove same upon notice from �he <br />�!y ,ird to � �:.ubhc proneity damaged Ihereby. <br />�1/l� S .t�! <br />� <br />4N0 AUiHO IZED THIS PERMIT MUST 8E STARTED WITHIN <br />tA0 DFYS OP DATE ERMIT IS ISSUEO AND THEREAFTER IS TO <br />i dE DILIGENTIY FUR UED TO COMFLETION. THIS PERMIT MAY 5[ <br />'� CANCELLEU BY THE CITY UPON ANl' STOPPAGE OF WORK ON THIS <br />i PROJECT OVER 90 DAYS DURATION. <br />