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( / <br />� APPlication For <br />PUBLIC WORKS PERMIT �a1e— 6-Z3-97 <br />MAY 1 8'I�� WORKS DEPARTMENT G(��vPubiic Works Pertnil ri � 7 Z z p <br />TO POSTIN6 3200CedarStreet , ��n <br />� �.:.,ozo� 2 s-e� ,fi p � e, <br />Ai�" � Building Permit # 55733 <br />�D u1 �G �,i.�t � <br />TYPE OR PRINT ONLY Y'Q�� �,�% �� � Publlc Works Fee $ �� 7-3Z <br />William Robinson 607 SE Everett Mall Way Everett 98208 353-8400 i <br />Owner Mailing Address Ciry Zip Phone � <br />Contact: Dave Robinson 353-8400 <br />Applicant Mailiny Address <br />Describe Proposed Work <br />PROJECT ADDRESS (if I:nown) <br />Soo _ < <br />Attach tour (4) copies oi plans for proposed work - Draw to scale and note the fo;lowing if appllcabie: <br />•Property Lines •Outline and dimensions of aIl �xisting and proposed structures on the lot •Existing and proposed utilities <br />•Centerline of sireet •Indicate North •Show any proposed grading changes •Show measurements <br />PERMIT CONDITIONS: <br />1. All calls for inspection shall be made 24 hours in advance - phone 259-8810. <br />2. All work sFall be performed in accordance with this 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 1-800-424-5555. <br />� Ci viC Guo�,�' z�o 6c �o nc <br />4��prv✓e of dr, 7 _ /8--�7 <br />wo�;�S be�}'. <br />�cr �la�,s <br />fvji �� Pu6�,-� <br />07-c^1-97 10:26At�i <br />q 97229 <br />OTHER 92.00 <br />PU/ REVIEW <br />259.00 <br />PW/ INSP. <br />1621.00 <br />TOTAL 1972.00 <br />A OR1057 <br />� <br />O <br />♦i� <br />V♦ <br />0 <br />a <br />CHEK 1972.00 <br />ACKNOWLEDGEMENT GF CUN�ITIONS <br />The undorsigned ownedapplicanl hereby �grees to hold ai�d save harmless <br />the City of Everelt from any and all claims lor damages, costs, expenses, or <br />causes of actlon lhat may arise because ot Installation and maintenance o( <br />the improvement or other right-ot-way use hereto applied tor and further agrees <br />te remove same upon notice from the City and to replaca public property <br />damaged thereby. <br />�%�\b( \ l Z 1 �uL S.Z <br />Sign f App Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 1B0 DAYS OF DATE PERMIT IS ISSUED AND �fHEREAFfER IS TO BE DILIGENTLY PURSUED TO <br />COMPLETION. iHIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANY STOPPAGE OF WORK ON THI3 PPOJECT OVER 90 DAYS DURATION. <br />