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Date 4/5/94 <br />.S <br />u <br />Applic�i,on For <br />PUBLIC WO�KS <br />¢ <br />O <br />Print or Type Only � <br />� <br />Doiac Enterarises PO Box 95 � <br />Donald <br />Applicant <br />Describe Proposed Work <br />Pro�ect Address (if known) <br />rn pn�TING_lL <br />PERMIT <br />C�O NO � 00 O � <br />QI N M M N M�O �Nlf �O <br />.A _ M � M ti <br />I�S������I��Yialiu <br />m a �� '�� <br />Address <br />Lip <br />PuElic WorMt Perm�t e 9�/ � 7/ <br />eiao. o�o�. • 44012 � <br />Publ¢ Work� Fa� <br />Tolsl Fee = <br />L�fs AOP� Fea PaiE i <br />BH�ncs Dua i � 0 � <br />002-32a�loi�e3/ <br />Phone <br />Foundations for house and garage to be moved on to property <br />Attach four (4) copies of plans tor proposed work • Draw to scale and note the following as applicable: <br />• Property Lines • Centerline of sireet <br />• Outline and dimenaions ol all existinp and • Indicate North <br />propoaed structures on the lot � Show any proposed grading changes <br />� Existing and propoaed utilities • Show meesurements <br />pERMIT CONDITIONS <br />1. All calis tor inepsctbn ehell be mede 24 hre. In advance - phone 25�10. <br />2. All work shall bs pertormed in aceordance with this permft end curront City of Everott Desiyn �nd Conatruetion <br />Standerds �nd Specificatlonn. <br />3. Cell Location Underpround 9ervice 48 hre. before you dip. TOLL FREE NUMSER 1-800�424555b. <br />� ��Lace �v�rdrai L S¢Gfro.-r <br />,S Re6��ld �'rtcw�.j/ f'n�e <br />6. Tix rvt�s �n 4, jocnn•i,� f/q�o�s <br />7, ��aFn PuOCili S7�"CCf <br />8, 1Pe�tir rv/fs alv�,9 �S%�'S?' ��tr�s <br />� <br />ApprOved <br />',/6- <br />FINAL INSPEGTION - <br />Approved as Constructed <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA BB201 <br />Phone: 259•BB70 <br />Date <br />�. /t�orf�t SIdP. , <br />W <br />H <br />� <br />� <br />� <br />O <br />� <br />� <br />O <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersfgned owner/applicant hereby agrees to hold and save harm- <br />less the City of Everett lrom any and all cleims for damege& costs, <br />expenses, or causes of action that may arise beceuse of installetion <br />and maintenance of the improvement or other right-oi•way use hereto <br />epplied for and further agrees to remove same upon notice trom the <br />City and to replece public property damaged thereby. <br />ISignature oPApplicant � �^�� <br />WORK AUTHORIZED BY THIS PERMIT BE STARTED WITHIN <br />�� 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUCD TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />