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Cate 7-23-92 �� `�I� r�m��wo,..os.mn._y�.�1— I: <br />TO POSTING �-s-93 e�nao�o� • 37490 <br />AppliCaiion For ' <br />PUBLIC WORKS PfERMIT °°°,o,,.;"° : <br />�e,,.00< <,� P, a s7 <br />. . � oaa�ce o�e 5 6 n� ' <br />Print or Type Only � � , <br />LARRY 6 JOAN HANSEN 1405 MADRONA AVE EVERETT WA 9E203 252-5403 <br />Owner Mailing Address � City 2ip Phone <br />CNARLES INGRAM 252-4958 <br />�OPlicant Ma <br />Describe Pmposetl Worx NEW CONSTRUCTION/SFR <br />Project Atlaress �if known� <br />Zip P�one <br />AOach lour �4� copies ol plans br pmposed woik � Dmw to scale and note t�e lollowing as applica0le: <br />• ProOerty Lines • Centedine of street <br />• Outline antl dimensions ol all ezisLng and • InCicale Nort� <br />pioposetl slmctures on ihe lol • S�ow any pmposed gmding c�anges <br />• Exlsting and pmposed utilities • S�ow measur¢menis <br />PERMIT CONDITIONS <br />1. All calls tor inspecP.on shall be matlo 24 hrs. in ativanco- phone 259•8810. <br />2. All work sha11 be petlorme�l in accordanco wilh inis permit antl curren7 City ol EuereU Design antl Lonstmction <br />StantlarEs and Specilications. <br />3. Cail Location Untlergmuntl Service 48 hrs. before you tlig. TOLL FflEE NUMBEfl 1•800•424•5555. <br />�i� Insf�i/ ne� "A " d <br />"1 Gu�.� .� y���T G�i-�"dcwa� <br />; v� a s PPi,- � b l�`c �vw � s�ti, s/�-���-!' <br />d,�^tL-Fi�on . <br />�� <br />�,�► I���— 8 Z4-�L <br />npproved lor ConsiNclinn Dale <br />�r"�.fc� 7. � " i 3 <br />FII.WL INSPECTION Dale <br />Approved as Consimc�etl <br />�PUBLICWORHSDEPARTMENT <br />3200 Cetlar Str^el <br />Everetl, WA 982JI <br />P�one 259�BB1C <br />ACKNOWLEDGEMEIJT OP CONDITIONS <br />Z <br />� <br />� <br />� <br />� <br />a <br />The untlersigned ownei/applicanl he�eby aqrees f o hold an0 save �arm� <br />less I�e Gly oi Everell Oom an� and ap claims loi tlama9es. cosls <br />expen5es, or causes of atlion lpat muy aricC bbcauso ol Inslallation <br />antl maintenance ol fhe impmvemecl or other rig�l�o4way use nereto <br />applletl IOi 2nd lur�her agrces to rPmove same upon nalice Irom ihe <br />C��;y antl t0 replace publm property tlamagetl there0y. <br />... �_ � ,�:=�,� <br />i <br />Siqnaturo ApOlicanl Dale <br />WORH AUTHURIZED BV THIS PERMIT MUST 9E STAFTED WfiMIN <br />180 DAVS OF DATE PeRIdIT IS ISSUE7 AND THEFEAFTEN IS TO <br />BE OIIIG[NTLY PURSUED TO COMPLETION. THIS PERMIT MHY BE <br />CANCELLED BV TNE qTY UPON ANV STOPPAGE OF WOFK ON THIS <br />PPOJELi OVER 90 DAVS OUPAiION. <br />