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i <br /> a <br /> �� i <br /> / <br /> �AAA�" Date ..7-1-91 Public Wo�bPe�ml�• � �-'S' <br /> � eiaa�oeo�.• 91/27237 <br /> r� .lpplication For <br /> O �' <br /> �" PUBLIC WORKS PERMIT PUEIicWoihaFee S <br /> ��� Ta�al fea <br /> lesf�n0�-Fee PaiE S <br /> � eaia��o o�e g 2D nn <br /> o�� Prinl or Type Only <br /> 41 <br /> y� <br /> pq�� Washo, Keneth C 2319 Everett Ave �verett WA 98201 252-9190 <br /> �4 f3 Owner Mailin9 Address City Zip Phone <br /> O�jp f+ <br /> N� Owner <br /> Qr <br /> hl Applicant Mailing Address City Zip Phone <br /> �M <br /> �H <br /> FF Describe Proposed Work �o car �arage detaclied ' <br /> 4M <br /> W <br /> �� W <br /> �� �� '� P�olect Address(i�Y,nown) H <br /> Attach lour(4)copies ol plans for propcsed work- Draw to scale and nole lhe lollowing as applica6ie: � <br /> • Properry Lmes • Centedine ol strect ♦^ <br /> • Outline and dimensions ol all exisling and • Indicale Norih V� <br /> pwoosed structures on the lot • Show any proposed yrading changes <br /> • Eaisting and proposed utilities • Show measurements /M <br /> W <br /> " DO NOT WRITE BELOW THIS LINE O <br /> ��� PERMIT CONDITIONS <br /> I i.All calls for Inspection shall be made 24 hrs.in advance•phone 259•8810. � <br /> 2.All work shall be pedormed ir,accordance with this permit and currenl City ol Everetl Design and Conslruction <br /> . � ; Standnrds end Specilications. <br /> ' 3.Call Location Undergrountl Service 48 hrs.belore you dig.�OLL FREE NUtABER 1•800-424-5555. � <br /> �` <br /> � �--' � <br /> � F�- <br /> I -- N <br /> O <br /> __ a <br /> ' !, 1 ACKNOWLEDGEMENTOFCONDITIONS <br /> IThe undersigned owner/applicant hereby agrees to hold and save harm� <br /> � _ less ihe City af Everelt trom any and all claims for damages, cosls, <br /> expenses, or causes ol action that may arise bewuse of inslallation <br /> �,�� �C/_I �7 p q and maintenance ol the improvement or other righl•of�way use hereto <br /> �/Y7LT�� / �/ '// applied for and lurther a�rees lo remove same upon nolice Irom Ne <br /> - Approved fo(Constru lion Date ���y, d lo replace public praperty damagetl ihereby. �, <br /> _/`-Yt�-'Ca- � 3-.,1Y- %Z _i. .. _ ,�c_ L�o 91 I <br /> FINALINSP[CTION Date --'- " � <br /> Approved as Construcled Sign tfre o Applicanl Date �, <br /> PUBLICWORKSDEPARTMENT H'����U HORIZEO BY THIS PERMIT MUST BE STARTED WITHIN <br /> 180 DAYS OF DATE PERMIT IS ISSUED AND THEFEAFTER IS TO <br /> 3200CedarStreet BE DILIG[NTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE I <br /> Everett.WA98201 CANCELLED BV 7HE CITY UPON ANV STOPPAGE OF WORK ON THIS <br /> Phone:259-8810 pROJECT OVER 90 DAYS DURATION. � <br /> I <br /> � <br /> I <br />