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Date _$/1.7J25 <br />i-I�-iz-z� � <br />ti <br />Applicalion For M� <br />PUBLIC WORKS PERM�IT <br />d <br />O <br />Print orType OniY ^� R������ �I I�' c1� � <br />r .r e p. <br />Cd <br />Y.� <br />DAVID HUDSON 4710 HARBOR LN EVT �8 <br />Ownei <br />iNaiNnu <br />WAYNE SCHARBACH (SCNARBACH CONST) 652-5876 <br />qpplieant M��hng Address <br />Describe Proposed Work <br />Prolecl Address 1�f known) <br />NEW DUPLEX (BASIC 1103) <br />G <br />II� � O I�fl O <br />.p vF O 3� O <br />.+ V7 CJ W N <br />H � ,.-i W <br />•.J 'W W <br />� 353-550 <br />Cit� <br />� J W iUi' Cc' <br />fil d S U� C <br />Y <br />G` �- <br />Publ¢ YJorkS Petmll • • J �� — <br />eia�. oer.�. = 49246 __ <br />Jic WCIXs Fee S <br />TOIaIFa.0 <br />Less Aoc�. Fee Paa S— - <br />� � �rlanre Juc 5 � _ <br />� m � <br />� � <br />� i,ic: <br />av�ii <br />u� u7 i <br />Zip <br />A�taCh fow �4) Gopies of plans to� P��V��ed wori: �rav: to s�ab� antl nc,te the'dlawing as applicable; <br />• property Lines • Centerline ot street <br />• Outline and dimensions ol all ezishng and • Intliwle Nor�h <br />proposed siructures on the lot • Shov. any r,roposed gretlinc chanyes <br />• Existing and proposed utilities • Shov� measurements <br />Phone <br />PERMIT CONDITIONS <br />y t..411 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 current Ciry of Everett Design and Construclion <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. <br />_�,�/r/�� 9/�/� <br />Approved for Ccn uction <br />� Dale <br />� <br />� � � r-s� <br />FINAL INSPECTION Date <br />Approved as Constructed <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Sireet <br />Everett, WA 98201 <br />Phone: 259�8810 <br />..,.cw�rH=: <br />W <br />I"' <br />s <br />�� <br />� <br />� <br />�p <br />Y / <br />� <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersianed owner/applicant hercUy agrees to hold and save harm� <br />less the Gdy ot Everett from any 2nd 211 ctaims for tlama�es. costs. <br />ezpenses. or causes of action that may arise because of installation <br />and mamtenance o! tne improvement or other right�oFway use hereto <br />a��ned ior and luriher a9�ees to remove same upon notice irom lhe <br />City oi:d to replaca pub6c property�maged thereby. <br />..�n.......... _...��..__... <br />WORK AUTHORIZED BY THIS PEFMIT MUST B[ STARTED WITHIN <br />tA0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTIY PURSUED TO COMPLETION. THIS PERMIT ��1AY BE <br />GANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />r •.;� <br />