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a�oi�cwo�ks o� ma= �� �3 <br /> Date 1l. 1 83 Bi09 �eo�.�' •$3�1_y695 <br /> Application "or _ <br /> P�BL�� PubhcYlorks�ee �� <br /> WOR��:S PERMIT -��a�F=e <br /> ��r naoi.F�o r��a S-�-- <br /> Balnnce Duo _ <br /> Print or Type Only � I��t <br /> cxnn Fverett lVA 987f1fi i"i4- SO1R <br /> lnnnrnt nr\IFI (1P�7FNT 1'0 BOh ��Y Z�p Phone <br /> Owner Mailing Address <br /> S31RC City Zip Phone <br /> Applicanl Mailing Address <br /> Describe Proposed Worlc <br /> single family resi.lence <br /> �� <br /> ProlectA.ddress(ilknown) L°t S �9 Intercity �"° <br /> �� <br /> Attach tour(4) copies ot Ulans for proposad work� Draw to scale and note�Ceo1�e line of tr�eet a�le: � <br /> O Property Lines • Indicate N�rih <br /> • Outline and dimensions o1 all ezis!in,�end • Show any proUosed graaing changes <br /> proposed structures on!he lot • Show measurements M <br /> � Existing and pwposed utilities �ii <br /> �����pp rypT�WRITE BEIOW THIS LINE � <br /> PERMIT CONDITIONS � <br /> i. All r.alls for inspection shall be made 24 hrs. in advance- phone 259•881 5. <br /> 2. All work shal! 6e pertormed in accordance with ihis pennit and current City of Everett Dcsign and Construction <br /> Standards and Specifications. � �� <br /> 3. Call Location Underc�round Service 48 hrs. be(ore you di9.TOLL FREE NUMBER 1•S00•424-5555. <br /> r <br /> � �. <br /> 4. Per approved plans signed L2/7/83 and preliminary plat approval 6-7 • r <br /> � <br /> M�' �� � <br /> .-; � <br /> � � . <br /> � V � <br /> � <br /> � <br /> � : <br /> ACKN0IJLEDGEFAENT OF CONDITIONS _ <br /> The undersi�ned ov+ner/app�icant hereby agrees to hold and save harm- _-� <br /> ---" less the Ciry of Everett irom any and all claims for damages, costs, ��� �. <br /> . � e;:penses, or causes of action thaf may arise because ot installation <br /> � and maintenance of Ihe improvement or olher righPof-way use herelo _ <br /> `����/ z�/ //!J� applied lor and fur�her agrees lo remove same upon no�ice from lhe � <br /> Date City and to replace public property damaged thereby. <br /> Approved fo Con}ruclion _ -- <br /> . ( � � . <br /> . i � �'�_. ^-. :1��i�C' O � �`.�C . ,�� � _�' � <br /> Date D te <br /> FINAI IN PECTION i natur of Applicant = <br /> Approved as Cons�ructed yJORK AUTHORI2ED Y THIS PERMIT MU57 BE STARTED WITHIN. <br /> �,`.��i,�� PUBLIC WORKS DEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THLREAFTER IS TQ <br /> 3200 Ceda� Streel BE DILIGENTIY PURSUED TO GOMPLE710N.THIS PERMIT MAY E�[ <br /> � Everetl,WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON TH�S <br /> Phona 259�8815 PROJEC?OVER 90 DAYS DURATION. <br />