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- - - ,� .- <br /> Date <br /> 4-20-95 P„���.,,o,.�Pa,m,�. _ <br /> 6iaq oec� . 481�_ <br /> qpplication F< <br /> PUBLIC WORKS PERMIT Pu'to�iFeeF^e 5 <br /> Less<ool.Fee Fa�.a $ <br /> Ealan�rDuc S <br /> Print or Type Only <br /> Robert Andre' 250 Heather Rd Everett 98203 259-3387 <br /> Owner \1a�iirv; 4r.dress Citq 7ip Phonr. <br /> Frans Thuyns Architect 259-4822 _ __ ___ <br /> Applicant Pf.:,�Ln;;Address City Zip Phone <br /> Describe Proposed Work addition of living_space &_garage ___ _ _ <br /> ------- <br /> - --------- ------ W <br /> Proiect Address lit known' 250 Heather Rd ____.____________ H <br /> Attach four�a)copies of plans�w Proposed worH � ��i+; to .r.ale�c,a nclr the!o�lcwmg as anulicahle: � <br /> • Properry Lines • Cen�erlinn of siree! ,A <br /> • Outline and dimensions of all existing and • Intlica�C Narth �� <br /> proposed siructures on the lo� • Shev+ any r.roposed c�ratling r,hanges <br /> • Existing and proposed utilities • Shr,w measuremenis M <br /> W <br /> DO NOT WRITE fiEL06V THIS LINE O <br /> PERMIT CONDITIONS <br /> 7.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 Speciticalions. <br /> 3.Call Location Underground Service 48 hrs.betore you dig.TOLL PREE NUMBER 1•800•424•5555. � <br /> ?UBL16 1NOp�S PERNIi O <br /> MO7 RE4UIRE� � <br /> OY / <br /> DATE ' " ' � `/s //� <br /> ♦/♦ <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> ihr�unnersiqnetl owner/applic2nt horeby agrees to hold and save harm� <br /> ------ �-"�--"i ;ess ;he Crty o� cverell irom any and ali claims tor damagcs. cosis. <br /> ; expenses. or causes ol action that may arise t�ecause nl installation <br /> . and maintrnance n! the improvement or other righl-ol�way use hereto <br /> i;pi,rr; for and �urihe� a9ree5 to remove same upon notice Irom ihe <br /> Approved fo�Consiruction ����" I'� C�!y and to replacz public property damaged ihereby. <br /> � <br /> I <br /> FINAL INSPECTION Date <br /> Approved as Constructed Signature ul Ap�lir.an! Date <br /> gg--�� 1NORK AUTHOF'IZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> /A�� PUBLICWORKSDEPARTMENT �90 DAYS OF CATE PERMIT IS ISSUE� A��� THEREAFTER IS TO <br /> 3200 Cedar Street BE DILIGENiLY PURSUED TO COMPLETION. THIS PERMI7 tdA'r BE <br /> �.,� Everett,WA98201 I CANCELLED BY THE CITY UPON ANY S70PPAGE OF WORK ON THIS <br /> Phone:259-8810 PRO.IECT OVER 90 DAYS DURATION. <br />