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-���:.. _ , . .. - - <br /> .� -z-g,-K (��{4�O Z � <br /> D2te 2'ZZ'94 � ��" 5 PuOLCWorksPmmits I 1 � <br /> ApplicatioP�Foi <br /> em9 oep� •— 43573 <br /> PIJBLIC WOR�(S PF��I������ �_�,(_ �� PubhcWorkgFee <br /> �t ro�a�F�a s <br /> O � Less AoO��Fee Paia S <br /> p �a— <br /> � tl Balance Due 5 <br /> Print or Type Only Q o � o o in o � o o v�i — <br /> �n (TN? UO d' O O b0 �0 <br /> T. .Y' � �M ~M � � � W ��UO� <br /> THE TREDFIAY CORP PO BOX 3tY14 �GVERE'fT WA 9S!203� 347-9"184 <br /> a e <br /> Owner Mai{ir�Ad�ss � 1 � �it� � � � Zip Phone <br /> 0 o � cox � u: � oLSow .-+ � <br /> ., oc� m � r� m > o �- o3 � w <br /> OWI�'ER i z�cr'"�n. o"�.. � n 4, �naaau7 � c=i <br /> qpplicant Mailing Atldress City Zip Fhone <br /> Describe Proposed Work TiEW ItOUSE <br /> LOT 16 & 17 BLOCK 6 OF PINEHURST <br /> a <br /> 1 I � <br /> ProjectAddress(ifknown) 2'�z'� n����d ��ent.� L <br /> r- <br /> Attacii lour(4) copi�s ot Plans for proposed work- Draw to scale and note the follo�ving as applicable: s <br /> • Property Lines • Cen�erline of slreet ♦^ <br /> • Outline and dimensions of all existing and • Indicate Norih V) <br /> proposed shuctures on!he lot • Show any proposed grading changes <br /> • Existing and proposed utilities • Show measurements M <br /> W <br /> JO NOT WflITE BELOW-�HIS LINE Q <br /> PERMITCONDITIONS <br /> 1.All calls for inspection shall be mad�2R hrs.in advance-phone 259•88 i0. � <br /> 2.All work shall be performed in accordance wi!h this permit and current City of Everett Design and Construaion <br /> Standards and Specifications. <br /> 3.Call Location Underground Service 48 hrs.before you dig.TOLI.FREE NUMBER 1•800•424-5555. � <br /> � <br /> � <br /> � <br /> � <br /> � <br /> �,,q.�p:� AL�5,5 �A Hf�yQ2'�NVG!7NC�pp'OVEL'" ACKNOWLEDGEMENT Of CONDITIONS <br /> 'lN A���� �CGGSS(cfOC2'Sn'�' MGG� G{(' $�5 Ti�e undersigned owner/applicant hereby agrees to hold and save harm- <br /> — I less the Gry of Everet� Irom any and all claims lor damages, costs, <br /> // ezpenses, o• czuses of aclion ihat may arise because of installation <br /> ��`�l �y„n 3.r? _�� and maintenance of the improvamenl or other right�obway use hereto <br /> � �� �"�•� � applied for and lurlher agrees to remove same upon notice from ihe <br /> Approved for Gonstrudion Date City and lo replace public properiy damaaed ihereby. <br /> ,�--��� <br /> / r.x' � _ � -/3 -!� -. � - �1 <br /> PI IN ECTIO,�� ��ate _i� "�l. q , /��':'_,(��/l!. i_./! _ <br /> Approved as Conslructed Signaf re oi AppliC nt , Date <br /> WOR AUTHORIZ D BY THIS PERMI�f MUST BE STARTED WITHIN <br /> PUBLICWORKSDEPAFTMENT iB0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TJ <br /> 3200 Cedar Street BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MNY' 3E <br /> Everett,WA9B201 CANCELLED BY THE CITY UPON ANY STOFPAGE OF WORK ON THIS <br /> Phone:259�8810 pROJECT OVER 90 DAYS DURATION. <br /> _.,_ti�._._. . __.._:. . .., .. ..,. . .�..... . . , �.,. <br /> .._ ._..__ _ . ,..�,.- , <br /> e..uns.m�r.r�; ' �'�_. �rr�azase�xomnn�+rMt!�?Il,RI!�"`n'( . <br />