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Date 5-22-95 � �j �j S <br />Application For . <br />PUBLIC WORKS PERM�T <br />p �=..�� -�� � r'i o - ;i ri _r� <br />Print or Type Onty T� F OSTING �� �= ��, �.� �� <br />- r� i r-� c; c; .r r_i c� <br />_ �:t ,�q in. C.I l(l <br />t : 1^� 4t .:l <br />�. �i <br />Lyle Blank PO Box 2266 Everett 982� <br />Owner <br />Owner <br />Applicant <br />rAa„in;nr.uross ::- <br />n.; <br />�,� <br />�i <br />_ `_� <br />M;,i6nq Address <br />;355-4725 <br />` —cnv <br />r; r�y �n �r to <br />CJ rl �.. Li f..l <br />�.� .J .-I b.l ,J <br />:sr �n o. ::: �n <br />Ciiy Zip <br />Describe Proposed Work new house __, Lot 2 Short Plat 1202-11-95 <br />Pro�eclAddresspfknown! �yo10___LQm.VCtrQ HVVnUI+___ <br />�% �7}—� � <br />Puoi�c wo�ws Pc.mn . / ��G7v <br />,'o � <br />6iJ9 Depl s �p�8 <br />o�„�,� Wo,�=F,.,, <br />Tolal Fee S <br />LB55 ADUI. FneVa�.^. S <br />;��fi^tS,�„ s 'I.PY' <br />,_� •� i, � <br />n. A I! 1 <br />, f':' V� <br />�+ r.� <br />i:i �i i.i Phnni: <br />_'s ! n L � <br />L.I C: <br />Ui v r � <br />--__�__— P�.nrv,---__— <br />Atlaeh four I�I coP��'s of Plans fo� pioposed r:urn � D�a�•: L� ,,:,i!...c,:� noic inc foilewing a; anphcabie. <br />• Propefty Lines • Centerline ��� 51r2ei <br />• Outline and dimensions of all exishng and • Irr!m.ab: North <br />proposed struCturr_s on �he lol • �nrnv any ;soposed {1��h�n9 ch�nges <br />• Eristina and propused utilities • Shn++ maasuremenis <br />6ELON' iH15 LIN <br />PERMIT CONDITIONS <br />1. All calls (or inspection shall be made 24 hrs. in advance - phone 259•8810. <br />2, All work shall 6e performed in acwrdance with this permit and current City ot Everett Desi�n and Construction <br />Siandards and Specitications. <br />3. Call Location Underground Service 48 hrs. betore you dig. TOLL FREE NUMBER 1•800•424-5555. <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everet�. WA 98201 <br />?hone:259-8810 <br />ACKN06','LEDGCGEENT OF CONDITIONS <br />W <br />� <br />— / <br />Z <br />O <br />� <br />� <br />O <br />a <br />ihe undcr�iqned ov:ner/applic.:nt heroby agiees to hold and save harrn- <br />less Ihe City oi Everett trom any and all claims for dama9es, cost_: <br />expenses. or causes of action ihat may arise her.ause ol installatio:�� <br />,;� d ma�nlenance o! ihe improvement or other right�o4,riay use heroto <br />a;��,br�d I�r and �iuther ac7ree=_ to remove samn upon notice irom �hee <br />C��!� �rd tr, ,eplaca uubhc nronerty damaged thereby. <br />! G �! ". o /ci <br />' n, re of ApPli an! Da:e <br />lN K AUTHORIZED PY THIS PERMff MUST BE STARTED WITHIN <br />!AO DFYS OF DATE PERh11T IS ISSUED AND THEREAFTER IS TO <br />BE DIUGENTLY PURSUED TO COMPLETION. THIS PERMIT �dAY B[ <br />CANCELLED BY THE CI fY UPON ANY STOPPAGE OF WORK ON THIS <br />PFOJEGT OVER 90 DAYS DURATION. <br />