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Date 1 >,�h���v,o,w,a�,m��. <br /> Application For mao.oeo�.+ <br /> PUBLIC WORKS PERMI"i Publ¢WorbGee -- <br /> .o�r�F« s <br /> �esa noo�Fse aa�o 5 <br /> Print or Type Only eaiance O�e s <br /> pW�e� �--'� Plan Check No: C 45699 SEPA <br /> Applicat.Date: 09/29/94 Phone <br /> Job P.ddrees: 322 HEATHER RD <br /> Owner: GROSSMAN ARTHUR <br /> Tenant: <br /> Applicant Propoeed Uee: SINGLE FAMILY RESIDENCE -- _ <br /> Desc. of Work: Phone <br /> DEN/BEDROOM/BATH ADDN <br /> Describe Proposed Work <br /> OFFICE SET JOB SET — <br /> APPROVED FOR PERMIT: DATE_/_/_ BY <br /> � <br /> Project Address(il knownl . � <br /> 4tlach four(4)copies ol plans lor PropOsed wu,k� Dr�v� to scale an�f ncte�he fo�lcwing as applicable: �� <br /> • ProC�erty Lines • Cen�erline ol street � <br /> • Outline and dimens�ons of all existing antl • Ir.dicate 4orth <br /> proposed slructures on Ihe lot • ghow any rroposed gratling changes <br /> • Existing and proposed utilities • Show measurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS O <br /> 1.All calls(or in;pection 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 Location Underground Service 4B hrs.before you dig.TOLL FREE NUMBER 1•S00•424•5555. � <br /> � <br /> UDLIC WORKS PERMiT � <br /> NOT FlE�UIREP � <br /> :Y Q <br /> �ATE y� 9� O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> _ The�ndersigned owner/applicznt hereby agrees to hold znd save harm• <br /> � less Ihe City ol Everett Irom any and all claims lor tlamages. costs. <br /> � ezpenses. o� causes of action that may�arise because ol ins�allalion <br /> � and maintenance o! Ihe improvemenl or olher right-of•way use hereto <br /> �roved for Consiruction I aPP��PC lor and luriher agrees lo remove same upon notice Irom the <br /> Date Ci:y antl to replace public property damaged Ihereby. <br /> I <br /> � <br /> IAL INSPECTIGN py�` I <br /> �roveC zs Constructed Signalure ol Apptican! Date <br /> �""� PUBLICWORKSDEPARTMENT '/dORK AUTHORIZED BY THIS PEfiM1T MUST BE STARTED WITHIN <br /> 3200CedarStreet 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> ��T Everelt,WA 98201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT �dAY BE <br /> Phone:259•8810 GANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />