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� ,�i'�l� (/<<�C., _� - ,`I <br />1/23/89 J —,�- <br />Date P„ni,� wo,�, ae,m�i . .'� =_ ?3_ _. <br />AppGcatien Foi �3�ng oeu�. • _ _.__. _ _ _ <br />PUBLIC WORKS PERMIT ����������,�•F�� ---- -- <br />.o�,,�F�� s_ <br />lessAnt�l FerPnN S <br />I Dalanr.r Oun S '� �%l�-- <br />Print or Type Only <br />Rental <br />Owner <br />3409 �erett Ave. EWerett <br />Maihng Address <br />�rz-:z�-Yo-�oy/-B3/ <br />259-6108 <br />Gry 7�p Phone <br />EVerett Construction & Excavating, Inc. 14220 S. Iake Crabapple Rd. Marysville, WA 98270 <br />Applicant Mailing Atltlress City Z'P 65�2h bb01 <br />Describe Pwposed Work T15Ca11 DEW 2�� water line LO polilt shop. ��� E� —�j-�' s/ O <br />Prolect Adtlress (il knownl z807 Highland Ave. E�erett, WA 98201 <br />Attach four (4) copies oi plens for oroposed work � Draw to sc:�le antl note ihe following a: applicable� <br />• Property Lines • Centerline of sireet <br />• Outline and dimensions of all eals�ing and • Intlicale Norih <br />p�oposetl structures on Ihe lot • Show any p�nposed gratling changes <br />• Existing and proposed utilities • Shcw measurements <br />PERMITCONDITIONS <br />1. All calls for inspection shall be made 24 hrs. in advance • phone 259•$810. <br />2. All work shall be peAormed in accordance with this permit and currenl City of Everett Desi9n and Construction <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800•424-5555. <br />'�, lr's i � _ t;.�,, z;, i,� ��..�T<I� f � � ../ � . <br />��.t� _ �/-:'.: ���;: . <br />(�7. .., /'�c:..'- , � C (�:c.l<.�% � <br />c� <br />��w,-��u � //2c/g') <br />Approved lor Co ction � Date <br />%<� " s/di� �� <br />FINAL INSPECTION Date <br />ApproveA as Gonsiructed <br />everetl � PUBLIC WORKS DEP.IRTMENT <br />w 3200 Cedar Sireet <br />01/:0/89 <br />, <br />NOOD14594 <br />DFT.20 <br />CHECt; <br />B:OSRM OOOAk42T.i <br />t35.�J0 <br />i35.00 <br />ACKNOWL[DGEMENi OF CONDITIONS <br />W <br />� <br />� <br />� <br />O <br />� <br />� <br />� <br />a <br />The undersigned o�vnevapphcant hereby agrees to hold and save harm- <br />less Ihe City ol Everett irom any and all claims lor damages, costs. <br />expenses, or causes ol action thal may anse because ol installntion <br />and mamtenance ol ihe improvement or other right-obway use herelo <br />apU��ed br and lurther agrecs to remove same upon noticc trom ihe <br />Gty and to replace pubhc property damaged thereby. <br />������f ��—,�y <br />nalurc ol,�AppliCant �—� Uate <br />WORI( qI�THORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 D�YS OF DATE P[RMIT IS ISSUED AND THEREAFTER IS TO <br />