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• ' / <br /> nppnwnon Por Date 4/i 5/99 <br /> �iw�� PUBLIC WORKS PERMIT ���, <br /> �c PUBLIC WORKS DEPARTMENT Public Wo-ks Permit N �_ <br /> 3200 Cedar Street <br /> Everett,WA 98201 (425)257-8810 Building Permit# C6Z182 <br /> TYPE OR PRINT ONLY ;� POSTING Nf1V 0 9 �Ib1 Public Works Fee$ %n� <br /> POHLAND TODD "n iiOi.LY 6805 SCEYIC DR NW MARYSVILLE 98271 360-654-9003 <br /> Owner Mailing Address City Zip Phone <br /> CONTACT: OWNER <br /> Applirant Mailing Address City Zip Phone <br /> Describe Proposed Work NEW HOUSc W <br /> - � <br /> . __ _ Y/ <br /> PROJECTADDRESS (if known) 3I�" HEATHER RD -`� �`9C W <br /> � � O <br /> Attach four(4)copies plans tc:proposed work-Draw to scale and note the following ii applicable: �� ��., . ..' � <br /> •Proporty Lines •Outline and tlimensions of all existing and proposed siructures on the lot •Ezistinp and'proposed utilitles•.�. , <br /> •Centedine of siree� •Indicate North •Show any proposed grading changes •Show measuren:ents �' <br /> DO P!OT WRITE BELOW THIS LINF ` ' Z <br /> � . . _, _.:t:,iiii _ .O <br /> PERMI'f CONDITIONS: ;7. ;� <br /> 1. All cails for inspection shall be made 24 hours in advance- phone (425) 257-88t0 _<� <br /> 2. All work shall be performed in accordance with this permit and current City of Everett Design and;� : � <br /> Construction Standsrds and Specifications. , <br /> 3. Call Location Underground Service 48 hrs. Cefore you dig.TOLL FREE NUNBER 1•800-424-5555. ♦�► <br /> \/1 <br /> q', ��Cht I �ne ,�-F-�oP rwn o-FF ��d si f�c c��a,w��- � O <br /> Ov�/V� �n k � �� y l o�e -lv � 5-E� b�t d r��-v,a�.c c ha n�e( a <br /> �(-�o+-e M1e (2�iS i h5 -I-o fr-ee -Flo�,✓ . �t i s �{'kG O� ne�T <br /> r�s`7o �i�bi b! (i'fl� {y o�{�1n �nc� l�-G�'.�i� �s¢wiGrra7 �{a� d✓h,�hare., <br /> J � <br /> -� Src� sGw-o✓ �s �fi�' 3-�d �I7 n ��o I <br /> �a, C r�d r.�� an �ti �s s � �c�sho��I be don.e i� r rh�nner -�h�£ <br /> �.��� w;// no-� i'�^�ao�E svrrov�dM� �ra�p,r-�cr. <br /> `' —7, (NS'�u�/ G'raS.�l� cc�-�rD��+�E �,'�t�i ayO-f PW l�s9u-(��; <br /> ACKNOWLEDGEMENT Of�CONDITIONS <br /> The undersigned�wnerlapplicant hereby agrees to hold and save hartnless <br /> '� the Ciry ot Everetl from any and ell claims for damages,costs,expenses,or <br /> ppro e or ens iuc e causes of action that may arise because of installation and maintenance of the <br /> i improvemenl or other righUof-way use hereto ary�ied for and fuAher agrees to <br /> '�"�/� ;- remove same upon notice from the Ciry 2nd i��replace public properry dam- <br /> � p,cz�,.�� 8—if- �o ag thereby. <br /> �ProvedSasEConsotructed Date ! ' �D � <br /> G <br /> gna u cen e <br /> yypRK ALJi}10R�Ir BY THIS FERMR MUST BE STAFiTED WfTHIN 180 DAYS OF DAIE PERMR IS ISSUED AND THEREAFfER IS iU BE dUCENTLY PURS�JED TO <br /> ppNpLETIOfJ.THIS PEFM1fT MAY BE CANC�lED BYhE CfTY UPON MN STOPPAGE OF W�7RK ON THIS PFiQIECT OVER 90 DAYS WRATION. <br />