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� i'� � <br />N <br />K�� .ti G <br />C y <br />��� <br />H a <br />O C O <br />y N "C <br />y H <br />� H � <br />H [4 O <br />c� • n <br />H <br />Z y <br />� H H <br />O N <br />O H <br />(p] C N <br />'Sa N � <br />H O N <br />i es <br />Date <br />AppliCation For <br />PUBLIC WORKS <br />Print or Type Only <br />Owner <br />Applicant <br />PERMIT <br />Plan Chr_ck No: 6 37114 SEPA <br />Applicat.Date: 06�23/92 <br />Job Address: 55 9 f.OWELL RD <br />Owner: PZOLZ, AL <br />Tenant: <br />Propoeed Uee: SFR/DECK <br />Desc. of Work: <br />DECK <br />Describe Proposed Wo OFFICE SET JOB SET _ <br />APPAOVED FOR PEAMIT: DATE_/_I_ gY <br />Project Address (it known) <br />I <br />Puol¢ worka Peemit • <br />Blpp OaPI. • <br />Public Wo�xa Fea � <br />Tctal Feo <br />lesa POC� Fee PaiO $ <br />Balanco Uue 5 <br />Zip Phone <br />Zip Phone <br />Atta�h tour (4) copies of plans lor proposed work • Draw to scale and note the following as applicable: <br />• properry Lines • Centerline ot street <br />• Outline and dimensions ol all existing and • Indicate North <br />proposed structures on the lot • Show any proposed grading changes <br />• Existing and proposed ulilities • Show measurement; <br />PERMIT CONDITIONS <br />t. All calis for inspection shall be made 24 hrs. In advance • phone 259•5810. <br />2. All work shall be peAormea in accordance with this permit and curreM City e Everett Design and Consiruction <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE N'•.MBER 1•$00•424•5555. <br />r � 1 <br />� � � �(/J-� i�L.L(LLC��� �� V <br />j U,,_,(1v Ld�r:�._ ���'L., /'� � <br />/�- ? I'- i �- <br />Approved lor Conslruction Date <br />FINAL INSPECTION Dale <br />Approved as Conslructed <br />;�_�PUBLIC WORKS DEPARTMENT <br />3200 Cedar SVicel <br />Everett,l'J� �B'L01 <br />Phone: 259�8670 <br />W <br />F <br />� <br />� <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harm• <br />less ihe Cily ol Everett Irom any and all claims tor damages, costs, <br />expenses, or causes of aclion lhat may arise hecause of inslallatior, <br />and maintenance ot the improvement or othcr right�of-way use hereto <br />applied lor and furiher agrees lo remove same upon notice trom the <br />City and to replace public properry damaged lhereby. <br />Sic�naWre of Applicant Da�e <br />WORK AUTHORIZED BY THIS PEFMIT MUST BE STARTED WITHIN <br />780 DAYS OF DATE PEfiM1T IS ISSUED AND TIIEREAFTER IS �TO <br />BE DILIGENTLY PURSUED TO COMPLETION. TFI�S PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORI( ON THIS <br />PROJECT OVER 90 DAYS DUFATION. <br />