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_ _ ,: <br /> _.• <br /> ���; <br /> 8/9/95 '. -- _ ��' ` � <br /> � Publ¢Wo�xs Pe m t �� �" � <br /> Date 49169 <br /> � 9ag.oeo�.+. <br /> ApplicatiU�*For <br /> PUBLIC WOR�CS PERMIT PubucVlorksFce <br /> iotal Fee 5 <br /> � L25sF0�1 P¢¢Pmtl S <br /> n <br /> O O O O O O � O O ealanca Due S � <br /> Print or Type Only � � o o in o �o 0 0 0 •o <br /> [� o .o •a <br /> � N �Md � M � � � PM7 <br /> .r M � M N <br /> Thiele D F 18542 Spr�,qgd�e Ct NW Se�t1eN, 98177 542-0943 (w) 388-3333 <br /> Owner �1ai�nyn Ac:.ress re 3 � dZ� � w �� 7_ip Phone <br /> In" OGtlU' = SHTp W C3 � U <br /> � OJJ W � CLJ � ¢ O W = S <br /> p sC 41 fi S Ul 0 fi 3 SL' UI N f_1 <br /> x�i <br /> Applicant M;ilina Address City Zip Phone <br /> Describe Proposed Work New house __ <br /> —_—_—__—_._ _ � <br /> Projecl Address(it knownl �fl01�CLnmer A�_ — �..4L2�Z$��.Y. W � <br /> Att�ch four(4)ropies ot plans for proposed wak� Drav: to sr.aL:ann note �he'ollcwing as apGhr.able: e� <br /> • Property Lines � Centerline ol street ♦� <br /> • Outline and dimensions ol all existing and o Indicate Norih V� <br /> proposed strucWres on the lot • Show any croposed greding changes <br /> • Exi,ting and proposed utilitie� • Show measurements � <br /> � DO ^IOT V:�RITE 6ELOW THIS LINE � <br /> PERMIT CONDII'IONS <br /> 1.All calls tor inspection shall be made 24 hrs.in advance-phone 259-8810. � <br /> 2.All work shall be pertormed in accordance with this permit and current Ciry of Everett Design and Ccnsiruction 1 <br /> Standards and Specifications. <br /> 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1-800•424-5555. <br /> -�, I�vvz�lcTxi n'��,5� '����(<,ll se�=�� sEu.� �,��o���A CC'1S{��G���-����. � <br /> �cx�se ��dz��o� . C�11 D�,nn�s G�z.belm���� (i�s���O�'� d-� � <br /> 33�t-74G3 ��; c�� �o s �r-�:��:�c� work. � <br /> 5� C.��ne[,-F., ,2c:�a-Ftx� dra;�e.�e-Ez� kJ,r� - �v,r�-�- drrl; v� �t ♦^ <br /> �'��t. o�- Lc� • ��� <br /> ic. tGee�� S�e�c c:le�✓.' o-F ca ; �^t. �de�r�S zt c�ll t���2S • O^ <br /> -7. C��-b �}- �tt� �sidewalKa�� ne�.r ���d c��d�m�c�.�-��J li <br /> �,m�c�e �l�er� t� c.�. �� be re.�a;v-ed�ne��l�c.ed ��J c�+�-�lq�ea- <br /> G1� 1{�S�ec"�r's d��i GG�TO�� � <br /> i <br /> � ACKNOWLEDGEIv'ENT OF CONDITIOI�lS <br /> � The undersigned owneN2pplic2nt hereby agrees to hold and save harm- <br /> � less the City ef Everett from any and all ctaims lor dam�ges. costs. <br /> � expenses. or cnuses of action Ihat may arise because of installation <br /> � � o //� C L I and mainlenance o! tne improvement or other right-oFway usz hereto <br /> W"���`-�� �/��/�7 apphe�. for and further agrees lo remove same upon notice trom Ihe <br /> Approved for Construr.tion � I C�;y�i,d to rr. c public property damayzd thereby. <br /> i c:=:�.c��Y v""'� <br /> FI�4AI !n!g?ECTION Date � Datn <br /> Approved as Constructed Signature of ApplicaN <br /> � WOP.K Al1THORIZE� BY THIS PERMIT MUST BE STARTED WITHIN <br /> PIIBLICINORKSDEPARTMENT 1q0 DAYS OF DATE PERMIT IS ISSUEL] AND THEREAFTER IS TO <br /> e�� 3200CedarStreet BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Everett,WA 98201 CANCELLEU BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259-�E310 PFOJEGT OVER 90 DAYS DURATION. <br /> r <br />