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- � 2a - -'% ' � � - <br /> PubLc Works Permil+ <br /> Date___g{S/�1 6leg Deo� +��.��- — <br /> qpplicalion For <br /> pUgLIC WO�iKS PERMlT Pu�To��FeeF�� 5 <br /> Less AOP�.Fee Paa 5— <br /> Balance Oue S <br /> Print o: Type Only <br /> Ken Har✓e 2423 Lombard Everett 982C1 252-8289 <br /> Owner <br /> Mailing Address Gi�y Zip Phone <br /> „oode Const. dba NW Garages 11217 - 60th St NE Lk Stevens 96258 P��one <br /> Applican� <br /> Mailing Address C��Y Z�p <br /> Describe rropo5ed WO�k C'nn tr r* aw nwrayA <br /> _ � <br /> ProjeclAddresslifknown) _ <br /> 2423 Lombazd � <br /> s <br /> Attach tour(4)copies of plans tor proposed work- Draw lo scale and nole ihe lollowinc�as applicable: � <br /> • Property Lines • Centerline of sireet <br /> • putline and Cimensions of ail existing and • Indicate North <br /> proposed struclures on the lol O Show any proposed�rading changes <br /> • Existing and proposed u�ilities • Show measurements M <br /> W <br /> DO NOT WRITE BELOW THi� � INE O <br /> PERMIT CONDITIONS � <br /> 1,All calls for inspection shall be made 24 hrs.in advance-phone 259•8810. <br /> 2.All work shall be performed in accordance with this permit and w«ent City of Everett Design and Construction I <br /> Standards and Specifications. � ' <br /> 3.Call Location Underground Service 48 hrs.before you dig.TOLI FREE NUMBER 1•S00•424-5555. <br /> O <br /> �Uf1-��.�` cuo-�—/�-�"��,c:��/� ���c.�-u, � � <br /> �,�;E��-�-�- � <br /> J �r pi o <br /> a <br /> �CKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees lo hold and save harm- <br /> less ihe City of Everell Irom any and all claims lor damages, costs. <br /> expenses, or causes of aclion ihat may arise because of installalion <br /> and maintenance of the improvement or other right-ol�way use hereto <br /> applied lor and further agrees lo remove same upon notice from ihe <br /> Approved for Construction Dale Cily and to replace public property damaged thereby. <br /> FINAL INSPECTION Da�e Date <br /> Approved as Constructed Signature of APplicaM <br /> everett PUBLIC WORKS DEPART�dENT <br /> gpRDA STOF DATE� PE M T ISEI�.�SUED AND THEREAFT�ER ISHTO <br /> � 3200CedarStreet BE DILIGENTLY PURSUED TO COMPLETION. THIS PEfiM1T MAV BE <br /> Evere�t.WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259�8�10 PROJECT OVER 90 DAYS DURATION. <br /> ..._� . �,., w..- .,.T---•�,..--,•,� ..,, , ;;r.-N.,�t . ..,..,-,- .._.�. -,�:.-� - �: . - _. . <br /> .., <br /> _ . _ .. . . . � `- <br /> .„ .....,..Y., �. .., _ � . . - . . . . . . - � - <br />