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Date— <br /> 11 1S/83 `"b����,k�P��8�3 1 697 <br /> eiec�oAot= <br /> Applicu�ion For <br /> PUBLIC '�i1/���C� PERfVI ��' PumicworksFee ,.1 <br /> Totol Fec 5 �V <br /> Less 1pol.Foe Paie $--� <br /> CalancoDue � �L"� <br /> Print or Type Only 6'�O 7� <br /> Duiardin Develo ment ;0 Box 5308 Everett l9A 98206Zfp '�4 no es <br /> Owner <br /> MailinJ Address City <br /> ;�ame phone <br /> — Mailing Address C��Y Z�p <br /> qpplicant <br /> single family residence _ <br /> Describe Proposed Work <br /> — � <br /> ProjectAddress(ifknown) T.ot ]�i TnYP�)' — � <br /> � <br /> AC:ach lour(4)copies ot plans for proposed work- Draw to erale and note lhe following as applicable: � <br /> O Property Lines • Centerline of street <br /> • Oulline and dimensinns of all exisling and O Indicale North <br /> proposed structures on the lol • Show any proposed grading changes <br /> • Existing and proposed utilities • SY�ow measurements � <br /> '� DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS � <br /> 1. All calls lor insUection shall be made 2A hrs. in advance- phone 259�881 5. <br /> 2. All work shall be periormed in accordance wilh�his permit and currenl City of Everett Desi9n and Const��clion <br /> Standards and Specificalions. �ni � <br /> 3. Call Location Underground Service 48 hr_=, before you dig.TCLL FREE NUMBER �•800•424-5555. ` F <br /> /� �. <br /> d� C <br /> 4. Per approved plans signed 12i�/g3 and preliminary p[at approval 6-79. <br /> M/ � � <br /> �p� �J: <br /> 6d. Ia <br /> �; <br /> �- ' <br /> �� '. <br /> AGVWOWLEDGEP.fENT OF CONDITIJNS - <br /> 7na unccrsignctl owner/appli�ant hereby agrees to hold and save harm- � <br /> "� less Ihe City of Everett trom any and all claims !or dama9es, costs, <br /> /// , / e�penses, or causes ef action ihat may arisa because of inslallalion <br /> / /�/ �/ ��� � i and maintenance of ihe improvement or other righf-of-way use hereto <br /> ��' ./ �4 / �t_/�� applied for and turiher agrees to remove same uF�on notice trom the <br /> Appwved f_ L'r�Gonslruction T �Dale Ci�y and to replace public properry damaged iheretry. _ <br />� a % -7�8� � � � �� C�2�'� <br /> FINAL WSPECTION Date D le '' <br /> g atur f Applicanl '� <br /> Approved as Construc <br /> WORK UTHOFI"L[0 Y THIS P[RMIT Ml1ST BE STARTED WITHIN <br /> evere�t PU6LIC WORKS DEPARTMENT 180 DAYS OF OATE PERMIT IS ISSUED AND THEREAFTER IS TO . <br /> 3200 Cedar Slreei 8E DILIGENTLY PURSUED TO COP1PLF���ON. TH�� PERM1IIT M�Y B[ <br /> Lverett,WA 98201 C�MGELLED BV THE CITY UPON AI 1 TOP'i,t L C �':;ORfti Q[J I itiS <br /> �,�4.,:j7 i i .n.�. 25� (i816 rvRGJ�CT O� -R '.-�0 DAYS DURATIOiI. <br /> Y <br />