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Date 2/16/93 V-�'z�j"' J <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Oniy <br />ra P�sT��� _R �i� <br />/ <br />�{ � <br />Publlc WOrkO Pe�mi� • � �/ �_ <br />Biag.Deo�.• '�9577 <br />PuDiit Works Fee <br />To�al Fea $ __ <br />iess AOG� Fee PaiE .4 /J�y <br />9alance0ue $ !/'/� <br />Sonshii�e Homes Inc PO Bx 1344 Snohomish 98291 334-2000 <br />Ownei Mailiny Address Cily Zip Phone <br />A1 Thom Same <br />Applicant Mci!inoANress City <br />Describe Proposed Work <br />Project Address (if known) <br />422 Madison Lot 3, SP tf�}- <br />Zip <br />Attach lour (4) copies of plans for proposed work • Draw to scale and nole the tollowing as applicable: <br />• Property Lines • Center!ine ot sireet <br />• Outline and dimensicns of all existing antl • Indicale Norih <br />proposed structures on the lot • Show any proposed grading changes <br />• Existing a�d proposed u:ilities • Show measurements <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hrs. in advance • phone 259-8810. <br />2. All v.ork shall be pedormed in accordance with this permit and current City of Everett Design and Consiruction <br />Standards and Specifications. <br />3. Call Location Underyround Service 48 hrs. before you di�TOLL FREE NUMBER 1•$00•424•5555. <br />n�(n/' �(L �/ <br />�1l '"Y � X <br />V- �.v � <br />!/�`Q'^ � Of / <br />l ��f <br />��� e � � .. <br />�� S �� �� C� �,� ° � n �L� � � <br />� -I o �� <br />►�� /.n1r/ <br />�n <br />Q�° °' �� � , -� <br />i � <br />� I <br />Z �G <br />Approved as Constructed <br />Date <br />-�-;;�� <br />- a'� =� - <br />- `�.- <br />ACKNOWLEDGEMENT OF CONDITIONS <br />�w <br />_I <br />� <br />a <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the Cily ol Everett Ir any and ail�claims for damages, costs, <br />ezpense or causes of ti n that may arise because of installation <br />and mai enance ot �he � rovement or olher righ�-of�way use hereto <br />applied or and further es �o remove same upon notice trom the <br />Ci�y an to replace publi propert;� damaged thereby. <br />'����WORK AUTHORI2ED IS PERMII' MUST BE STARTED WITHIN <br />PUBLIC WORKS DEPARTMENT �g0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />� 3200CedarSlreet BE DILIGENTLY PURSUED TO COMPLETION. THIS PEAMIT MAY BE <br />T Everett, WA 98201 CANCELLED BY THE CI7Y UPON ANY SiOPPPGE OF WORK ON THIS <br />Phone:259-8870 PROJECT OVER 90 DAYS DURATION. <br />