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.Date—B_2b_94 �' � ^ 5� 3Z2 <br /> A+Me Wak�P�rmll• <br /> Application For � ewo.o•P�.. � _ <br /> PUBLIC WORKS PERMIT � ���KWork�Faa <br /> To�.��.. s___ <br /> Ln�Aopl Fee P�in S <br /> Print orType Only � 8 �j 8 � � e.�.��.n�, s—3$'_° <br /> . <br /> � xx�� <br /> Ceneral Weldi PO Box 1 L nwood WA 80 8— 66 TO POSTING � -� <br /> , Oweer Mading ACdress ,� � � Zip <br /> P�one <br /> Babe Luedke $ � <br /> � APDBcant Mai6na Address Citv ZiP Phone � � <br /> Oeseribe Proposed Work _ loadinR dock 6 storaqe area <br /> Pro��ct Addresa�if knownl 2530 Hewitt Ave � <br /> � � AttaCh four(4)copiea of plans for proposed work• Draw to>cale antl nole tha lollowing as applicable: � <br /> , • Property Unes � <br /> � • OutNne and dimensions ol all existin antl � Centerline of street � <br /> 9 • Intlicate North <br /> � propose0 atructuros on t�e lot • ghow any proposed grading changes <br /> • Ezistinp and proposed utliities � Show measurements <br /> f ' DO NOT WRITE BELOW THIS LINE � � <br /> I PERMITCANDITION8 O <br /> i1.All wlls for inapec.ion ehall be made 24 hra.in advance•phone 259�8810. <br /> � 2.IUI work ahNl be performed in eccoMance with thla permit and current Ciy of Everett Denpn and Conatruction ' ; <br /> Shnderds end Spscirycatlona <br /> � 3.GII t.acetlon UnderyrounC 3ervice 48 hra before you dip.TOLL FREE NUMBER 1-800�424•5555. � , <br /> � <br /> ' �.GG �a�a�a.cil�. G.�ox� /! <br /> I !<l�rin� !o <br /> � ,�ye t �-� �. ��o E� � <br /> ; . �� � <br /> w� w�.,E �� d� ,� -� 6.. d�,. �,.. <br /> GJe� � (,e o�i+�w �u. Ce�, t��.�,.a� '�30� ��3e�. //� <br /> V♦ <br /> S �'Oh�Qtf f'I�s �i/,��iG 4/oi>ES insPecf,�r ,Q�nn:s C�a6lc�+�n ; . <br /> � 3 fL7yo� 0 <br /> �1�.-e s!�r�.:,9 Sio�eusl�f' k..br,f �r a �e l� ViSi i�, � <br /> I <br /> � ACKNOWLEDGEMENT OF CONDITIONS <br /> i <br /> The undersiqned owner/applicant hereby agrees to�old anA save harm• � <br /> � � less Iha City of Everett Irom any and atl claims for Camages costs <br /> � � ezpenses. or causes of action that may aris? because of installation <br /> � ��� ��s�� � and maintenance of the improvement or other right-of-way use herefo <br /> j Approved lor Canstr� tion pa�P I appi�r.0 lor and lurther agrees to remove same upon notice irom the <br /> � � C�ty and to replace publlc property damaged thereby. <br /> i t � <br /> J FINAI INSPECTION � Date ��il`.` ��O�� � q— (�-9 y- <br /> i ApproveE aa Constructod Signature of Applicant Date <br /> � � PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> I 3200CederStrcet �80 OAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everetl,WAgB201 BE DILIGENT�V PURSUED TO COMPLETION. THIS PERMIT MAV BE <br /> Phone:258•BB70 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON TMIS <br /> PROJECT OVER 90 DAVS DURATION. <br />