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Date 6/20/94 � ' (Z' 2.8" �- <br />Application For iy <br />PUBLIC WORKS PERM�I' <br />� <br />Print or Type Only �'� p�STING 2�!� � � g g S�� <br />� �ddd.od <br />[� �Y N N N N <br />N N N N « � <br />Baker Brock 5632 Evergreen Wy 98203 � 3.43-8833 <br />Tim Cameron <br />rlicant <br />Descri6e Proposed Work <br />Ar.drEss <br />353-8833 <br />rr:,ri:� .dd�ess <br />Neto duplex <br />%5 �% —___...____—__— <br />ProjectAddresslillcnown! ��i"� LOl(J�/�, <br />Gity <br />' r �; i `: <br />?.°.', <br />� �J� � <br />Pi�blic WorFs Permil a _ ��_ _ <br />aia� o�•o� , 44658 <br />PeliM1CWork.Fee � <br />TolTl Fec S <br />Less aonl Fn.� pa�,p S <br />��.g,.��,� s ZO- <br />0 <br />O <br />M <br />a����������W <br />��o�,o ��� <br />Lot 2 S.P. 24-91 <br />Attaeh fourl4) coPies of plans foi P�ono;ed wu:�: � Dra�^ to -c.ii•.-r an.7 ncha Uia foiluwmg as anPlicabie: <br />• Property Lines • Centerline nl strr,et <br />• Outline and dimensions of all exishr g and • Indicate Norih <br />proposetl s(ructures on the lot • Show any r,roposed gracinri r.hannes <br />• Existing and proposed utilities • Show measurements <br />DO <br />PERMIT CONDITIONS <br />1. All calls (or inspection shall be made 24 hrs. in advance- phone 259-$$10. <br />2. All work shall be performed in accordance with ihis permit and current City of Everett Design and Construction <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. be(ore you dig. TOLL FREE NUMBER 1•800-424-5555. <br />W <br />� <br />�w <br />_ / <br />Z <br />� <br />ACKNOWLEDGEldENT OF CONDITIONS <br />Th�9 unher�iqned oWne%appliCant h�feUy a9ree5 io hold anC SavC harm- <br />�� tess the Gty of Everett from any and all claims lor dama9es, costs. <br />e*penses. o� causes of action that inay arise because ol installation <br />and maintenance o! ihe improvement or other right-of-way use hereto <br />3FP���d for and further aqrees to remove sam? upon notice from ihe <br />C'.•' , nd � replaca publl1: �oo � am. ged thereby. <br />�� � <br />ignaWre of Applican! Date <br />INORK AUTHORIZED BY THIS PERMIT MU3T BE STAR ED WITFIIN <br />180 DAYS OF DATE PERMIi IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT ��iqY 6F <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAVS pURATION. <br />Approved as Constructed ✓���y � <br />PUBLIC WORKS DEPARTMENT I <br />3200 Cedar Street <br />Everett, WA 98201 <br />Phone:259�8810 , <br />