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C�� <br />TYPE OR PRINT ONLY <br />Application For <br />PUBI_IC �J1IOFiKS PERMtT <br />PUF3LIC WORKS DEP,4RTMENT � <br />3209 Cedar Street .�pN 2 ,�, <br />Everett,WA98207 259-Bg'ftf <br />!v :,��TING <br />/ <br />Date S/5/98 <br />Public Works Fermit p �/y� <br />I <br />euilding Permi� s _ 59757 <br />Public Works Fee $ <br />FIARCHEL JOE °929 NE 124TH KIRKLAND 98034 425-820-8384 _ <br />Gwner Mai:i:i9 Address City Zip Phone <br />TED (7 LAKES CONSTRUC7'ION) 360-652-7202 <br />Applioant Mailing Address City 2ip Phone <br />Describe Proposed Work <br />PROJECT ADDRESS (if known) <br />MANUFACTURED HOME <br />Attach four (4) cepies of plans for proposed work - Draw to scalo and note thu following if applicable: <br />•PropeAy Lines 'Outiine and dimensions of all existing and proposed siracWres on the lot •Existing and propoaed utilities <br />tientedine ot sireet •Indicate NOAh •Show any proposed grading changes •Show measerements <br />PERMIT CONDITIONS: <br />1. All calls for inspection shall be made 24 hours in advance - phone 259-8810. <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and <br />Construction Standards and Specifications. <br />3. CaII Localion Underg�ound Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. <br />�'� S+a.ve..� Gohnec('i� ov� ia 30'� D. i, tarc� mr,�h o�ts �t�' <br />��'2.n s✓bm; �'fG� w��r,�-m� f sfiu,�p� `�ppr��d f�•j <br />rvl � �huel L, Sctie►„�r.r P� E� <br />�1�W1 �. �/r����- <br />Appmved for Construct;on ; Date <br />-���a � S /�- j" `" <br />� -�--- r <br />FINAL INSPECTION Date <br />Approvec' as Constmcted <br />ACKNOWLEDGE�dENT OF CONDITIONS <br />The undersig:�ed owner/applicanl hereby agrees to hold and save harmless <br />the City of Everett fmm any and all claims for damages, costs, expenses, cr <br />causes of action that may arise because of installalion and maintenance of <br />;he improvement or other righf-of-way use hereto applied for and furiher agrees <br />to remova same upon notice from the City and to replace pubiic property <br />damaged thereby. <br />���, � ��.�1✓s� l�/9% <br />Signature o( Applicant Date <br />WORK AUTHORIZED BY TFIIS PEPMIT MUST BE STARTED IYITHIN 780 DAYS OF DATE PERMIT IS ISSUEG AND ��FiEREAFTER IS TO BE DILIGENRY PURSUEU TO <br />COMPLETION. THIS PERMIT MAY BE CAN�ELLED BY THE CITV UFON ANY STOPPAGE Of N'ORK ON THIS PRO,�[CT OVE(7 9� DP�YS DURATION. <br />