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�� r <br /> o� x . � <br /> t�yy �LLI I <br /> y�� Date 1/2R/Q1 �� /� v�oi�cwo�hsaermn+ _ �i <br /> �y .b Applica�ion For eme oec�.• Q1/96Z74 <br /> ��� PUBLIC `dVORKS PERIIAIT <br /> PUGI¢works Fec <br /> y .o�a�Fe� S <br /> ��i Less ADPI Fee Paid S <br /> O��� Print or Type Only oa�,�=��o�� s <br /> en <br /> �Y �CC�� <br /> S y� Alfred R. MCCune 7402 E. Heather Way Everett 98203 353-9530 <br /> r� Owner Mailing Address Ci�y Zip Phone <br /> HH <br /> gy <br /> � <br /> ��� � — <br /> Applicant Mailing Atldress City Zip Phone <br /> ��� Describe Proposed Work Addition to SFR + car�,+oxt & dp.�k <br /> W <br /> Prolect Address�il known) �402 E. Heather Way — L ' <br /> r <br /> Atlach four(4)copies ol plans for pmposed work- Draw to scale and note the lollowin9 as applic;ble: � '. <br /> • Property Lines • Centerline of s'reet /^ � <br /> • Oulline and dimensions of all ezisting and • Indicate Norih V� <br /> pro4psed structures on ihe lot • Show any proposed grading changes <br /> • Exisling and proposed utili�ies • Show measurements � <br /> DO NOT WRIiE �ELOW THIS LINE � � <br /> '�1 PERMIT CONDITIONS <br /> 1.All calls for inspection shall be made 24 hrs.in advance-phone 259•8810. � <br /> 2.All work shall be performed in accordance with this permit and current City of Everett Design and Construction <br /> '�/ Standards and Specifications. <br /> 3.Call Localion Undergrountl Service 48 hrs.before you dig.TOLL FREE NUMBER 1•800•424•5555. � <br /> ' 1 <br /> I_I ��, «�����.�:� �J� ���tiz..� � <br /> 1 1f�,f�� � <br /> � / -3/-9/ ♦A <br /> �1 V♦ <br /> �' O <br /> - a <br /> _� <br /> _� <br /> ACKNOWLEDGEAIENT OF CONDITInNS <br /> � <br /> The undersigned owner/applicant herehy agrees to holtl and save harm- <br /> �' — less ihe Cily of Evere�t irom any and all claims lor tlamages, cosls. <br /> _ expenses, or causes of aciion ihai may arise because of installation <br /> antl maintenance o� the improvement or other righl-oFway use hereto <br /> `� � applied for and furiher a9rees �o remove same upon no�ice Irom ihe <br /> Approved lor Consiruction �a�� City and to replace puhlic property tlama9eA Ihereby. <br /> FINAL INSPECTION Date �I <br /> Approved as ConstNctetl SignaWre ol Applicant Da!e <br /> evemtt PUBLIC WORKS DEPARTMENT �NORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIM <br /> O 3200CedarStreet 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO I <br /> Everett,WA 9B20i BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAV BE I <br /> Phona 25&8870 CANCELLED BY THE CITY UPON ANY STOPPAGE Of WORK ON THIS <br /> PROJECT OVEH 90 DAYS DUFATION. <br />