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Date 11-2�-93 �n P�CT��� 1 _( ��/_R`� <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Public Works Permit s � Q � <br />eiaa oeP�., 42787 <br />Publie Wmks Fee <br />Total Fee $ <br />Less AOPi. �ee Peitl $Tyµ:�q�—.�T---- <br />BalancaDue S�'�b�i�'+�T' <br />Apple America Ltd Prtnrshp of WashinQton 919 N Mic}_Ran Ave Ste 1919 Chica�o IL 60611 <br />Owner Mailing Address City Zip phone <br />;Z/ <br />Chiodini Associates 700 Corporate Park Dr 1k250 St Louie MO 63105 (314) 725-5588 Steven <br />Mailing <br />City 2ip <br />� - _ _' --:..n�7�C��.Y'%u^�J��i4�iLil-/I%Si � <br />. i i . <br />�roject Address (if known) <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the following as applicable: <br />� Property Lines <br />� Outline and dimensions of all existing and <br />proposed structures on the lot <br />• Existing and proposed utilities <br />• Centerline of sireet <br />• Indicate North <br />• Show any proposed grading changes <br />• Show me2suremenls <br />PERMITCONDITIONS <br />1. All calls for 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 �esign and Constructlon <br />Standards and Specifications. <br />3. Cail Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800•424•5555. <br />� %J.�r �.-�� p.�s � �e � .� - / - 9 � <br />/ <br />��o <br />O�� 0.� 199R <br />MP� P���.. <br />...�oF��o.� ���° <br />. ,S <br />�•�����y``,�d�oA <br />ACKNOWLEDGEMEl�'OF CONDITIONS <br />Approved as Constructed <br />PUBLIC WORKS DEPARTMENT <br />3200 Ceder Sireet <br />Everett, WA 98201 <br />Phone:259•8810 <br />W <br />H <br />� <br />� <br />0 <br />� <br />� <br />0 <br />a <br />7he undersigned owner/applicant hereby agrees to hold and save harm- <br />less the Ciry of Everetl irom any and all claims for damages, costs, <br />expenses, or causes of action that may arise 6ecause of installation <br />// and mainfenance of ihe improvement or other right-ohway use hereto <br />� applied for and further agrees to remove same upon notice from the <br />Dat Ciry and to replace public properry damaged thereby. <br />Date <br />.�- <br />� <br />Date <br />I�VORK AUTHORIZED BY THIS PERMIT MUST BE STAflTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED P.ND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY S70PPAGE OF WORK OY THIS <br />PROJECT OVER 90 DAYS DURATION. <br />