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'.yC t�"'H-7 <br />t7?y <br />p�75 <br />9 H [/� <br />H �3 <br />y zH <br />� H� <br />� H �,O-7 <br />VJ H <br />� H �G <br />O �-+ <br />H [�+7 O <br />G�� f� <br />� H� <br />HH <br />C7 y <br />O H <br />C] �7 y <br />t7 � [rs7 <br />H O f�n <br />Date 9�12/91 . , <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />PuO��c Workf Parm��t � <br />e�aa.oew.+ 91/2?693 -- <br />PYb�iC WOrkS FBB 5 <br />TotalFea — <br />Less AopL f'ee PaiE $ — <br />sai.��ce o�ie 5 — <br />Tammv Smith �1n7 r' qton aV P rt wn 9a^n� �SS-FF>> <br />Owner M1laiiing Address C��Y ZiP Phone <br />COHO Const. PO Box 1282 Nlarysville, WA 98270 653-2646 COCOL110JC _ <br />.4ppiicant MaJing Address City 2ip Phone <br />�escrme Proposed worK �nstruct new detached <br />Proicct nadress Iil known) Z107 Lexinqton Ave. — <br />At�ach lour in� copies ol p�ans lor proposed work - Draw to scale and ��ote ihe lollowing as applica6lr. <br />• proDer�Y Lines • Cenlerline of street <br />• Outline antl d�mensions of al� exi;img and • Indicate North <br />proposed s�ructures on Ihc lot • Show any proposed gr,�din9 changec; <br />• Existing and proUoseA utilities • Show measureme��fs <br />PERMIT CONDITIONS <br />'� ` 1. All calls for inspeclion shall t? made 24 hrs. in advance � phone 259•8810. <br />� , 2. AII work 5hall be pedormetl in accordance wilh �his permit and cu�renl City o� Everet� Desi9n antl Constrcctinn <br />�'°" Standards and Specilications. <br />3. Call Localion Underqround Service 48 hrs. belore you ]ig. TOLL FREE NUMBER 1•800•424•5555. <br />E . �� <br />. -� <br />E "1 <br />�,. .� <br />� ...,u�� <br />G � <br />m � <br />%� il i / <br />< ��. �_ l- ,. ./'. . . , �. / /_' . . � <br />for Construction <br />Date <br />FINAL INSPECTION Daie <br />Appwved as Conslrudod <br />PUBLIC WORKS DEPARTMENT <br />���3200 Cedar Street <br />Evcreu, WA 90201 <br />Phono: 259�6810 <br />W <br />� <br />0w <br />� / <br />f,GF:NOIVLk_DGEP4[NT OF CONDITIONS <br />The undersigned ovmm/apphcant hmcUy agrees lo hold. nA save harm- <br />less �he Cily ol Everett from any and ail cla�ms lor damanes, cosis. <br />expenses, or causes ol aclion ihat may arise bec�use o� insl. ila�ion <br />and mamienance of Ihe improvement or olher rigM�oFv+ay use hereto <br />applied for and further a�rees to remove same uP��� ��ctice tram ine <br />Cily and to rep�ace public proPer�y dama9ed thereby. <br />Si9nalure ol Applicant �''�� <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WIIHIN <br />180 OAVS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DIL13ENTL'! PURSUED 70 COLIPLETION. THIS PERMIT 1.1AY B[ <br />CANCELLED 6Y' TI IE GI i Y UP[1N .1M' STOPPAGE OP WORK ON THIS <br />PROJEGT OVCR'10 DA1"5 pUHATION- <br />