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Pu�l¢Worns Pcrml�• V F �� <br /> Date 11 15 83 8109.Dep4+ 83/12 4 ___ <br /> Application For . <br /> PUBL.IC WORKS P�RiVIOT PuoTaelFeaFoe S 7� <br /> Less ApP�-�ee Paitl 5 <br /> �— <br /> BalanceDuc S ��� <br /> Print or Type Only <br /> DUTARDIN DEV T �P'iF�T PO I30x �'�ng Fverett iVA 98206 334-5018 <br /> Owner <br /> MaJing Address City Zip Phone <br /> Same zi Phone <br /> Applicant Mailing Addre>s City P <br /> DescribeProposedWork single family residence <br /> _ ��� � <br /> ProjectAddress(ifknown) Lot 4 1-2� Intercity � <br /> � <br /> Al�ach four(4) copies of Plans ior proposed work- Draw to scale and no�e the lollowing as apP!icable: � <br /> 11 Properry Lines • Centerline of street <br /> e Cutline and d�mensions of all existi�g and • Indicate North <br /> proposed slructures on the lot • Show any proposed gradin9 changes <br /> • Exisling and proposed i�tilities 11 Show measurements /� <br /> W <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERtd1T CONDITIONS � <br /> 7. All calls for inspection shall be made 24 hrs. in advance� phone 259-881 5. <br /> 2. All work shall be pertormed in accordance with this permit and current City ot Everett Design and Construction <br /> Strndz�,l:,and Specific2tions. � �� <br /> 3. Call Locntion Underground Service 48 hrs. betore you dig.TOLI.FREE NUMBER 1•800•424•5555. Y <br /> r <br /> � r <br /> 4. Per approved plans signed 12/7/83 and preliminary plat approval 6-79. <br /> �i i � • <br /> m : <br /> � � �: <br /> � <br /> v � �. <br /> � � <br /> m <br /> r : <br /> r <br /> �CKNOVJLEDGEMENi OFCONDITIONS �' : <br /> �-�-. <br /> The under�igned ownedapplicant hereby agrees to hold and save harm- ` .. <br /> less the Gity ef Evere�t trom any and all cl..ims tor damages, cosis, . <br /> expenses, or causes of aclion that may arise Secause ol installation <br /> and maintenance of ihe improvement or other right-ot-way use hereto <br /> applied for and furiher agrees to remove same upon nolice frem the _ <br /> „pproved lor � ruction �^te City and to replace public property damaged lhereby. '- <br /> � ~ / L�// <br /> � � , ^ !�+ �—�{— '� <br /> PINAL WSPECTION �a e Datp ��� <br /> ApP�oved as ConsVucted Slg ature f Applicant <br /> WORK A THORIZED BY' THIS PERMIT MUST BE STARTED YJI�1FiIN <br /> eveictt PUBLIC WORKS DEPARTMENT 180 DAYS OF DATE PF.RMIT IS ISSUED AND THEREAFTER IS TO <br /> � 3200 Cedar Street BE CILIGENTLY PURSUED TO COMPLETION. THIS PERM�T MAY BE <br /> EveretL WA 98201 CANCEI_LEG BY THE GTY UPON ANY STOPPAGE OF WORK O�7HIS <br /> n�,one 259�6815 PROJECT OVER 90 Df.YS UUH�ITION. <br />