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Ziz2i93 TO POSTING �0 � c~y <br />Date <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Jack L Dunlap 7523 Lower Ridge Rd Everett 98203 355-8676 <br />Owner <br />Owner <br />P.ppli��ant <br />Garage <br />Describe Proposed Work - <br />Project Address (if known) <br />Mailing Address <br />Mailing <br />7523 Lower Ridge Rd <br />City <br />Zip <br />Pu01ic Works Permit s � � f" � <br />eie9. oeo�. • 39647 <br />Puelic works Fee $ <br />Total Fee <br />Less hoa� Pee Paia S <br />Balance 0ue $ ZU O'� <br />Attach four (4) copies of plans for prop�sed work - Draw to scale and note the following as applicable: <br />• Property Lines • Centerline of street <br />� Outline and dimensions of all existing and • Indicate Norih <br />proposed structures on the lot • Show any proposed grading changes <br />• Existing and proposed utilities • Show measurements <br />Phone <br />Phone <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hrs. in advance • phone 259•8810. <br />2. ti i work shall be periormed in accordance with this permit and current City o' Everelt Design and Construction <br />Standards and Specitications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•S00•424•5555. <br />T. f�/Ior/i de �-r�s.of, Lo.,�.-o !¢s G��r'ea7�� d,/y ffie f�v6l.0 <br />Wp,-,E,s Ti,tPe c tv r <br />s. /��,o �;�y sf.��f ��`�„ <br />o,��� 6� ot�,>,,;,, - d���: <br />,����--�� ��y/9� <br />Approved for onstrydion � Date <br />���� - 9� �� <br />FINAL INSPECTION Date <br />Approved as Constructed <br />�PUBLIC WORKS DEPARTMENT <br />,��3200 CedarSireet <br />Everett, WA 98207 <br />Phone: 259•8810 <br />2f all f;�es, <br />W <br />� <br />� <br />� <br />i <br />� <br />� <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the Cily ol Everetl from any and all claims tor Aamages, cosls, <br />expenses, or causes of action that may arise because of installation <br />and maintenance of the improvement or othur righboFway use hereto <br />applied for and further a9rees to remove same upon notice from the <br />City and to replace public properry damaged theieby. <br />:2 0 <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED 6Y THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />