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Date 7/18/95 <br />Applicetion For <br />PUBLIC WORKS <br />Print or Type Only <br />TO <br />� <br />PERM�!' <br />POSTING "'�Y 1_ � <br />r_ <br />N <br />ti <br />.+ <br />���i:�h <br />O� O.p.� OI� <br />N N M M � <br />.n <br />Pupl¢ Wore� Wrmil • • � � O / <br />eiao o.w . 48973 <br />PuElic Worke fN S, <br />Ta1N Fap - <br />leif �GOL Fee PeiO f �' <br />a.�.� g^� s <br />Applicant <br />Describe Proposed Wor:, _ Nev houee <br />Project Address lif known� .(yj�5 Hi a�A^��— T.ot 2 SP <br />AltaCh four (4) copies ol plaiu lo� ptoposed work � Drav: �n scaL+.ina note the lo�lowing as applicable: <br />• Property Lines <br />• Outline and dimensions ol all existing an� <br />proposed structures on the lot <br />• Existing and proposed utilities <br />I� <br />Approved for <br />• Centerline of sireet <br />• Ind�cale Norih <br />• Show any proposeA gradin9 cha�ges <br />� Show measuremenis � <br />PERMIT CONDITIONS <br />1. All calls for inspection shell be made 24 hrs. in advance � phone 259-8810. <br />2. All work shell be peAormed fn eccordance with ihis permit and current City of Everett Design end Conatruction <br />Standards end Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800�424•5555. <br />FINAL INSPECTION <br />Approved as Constructed <br />����PUBLIC WORKS DEPARTMENT <br />3200 Codar Street <br />Everetl. WA 98201 <br />� Phone:259-8810 <br />I <br />Z�i �"' i <br />Dale i <br />� i <br />i�T7 <br />Date <br />ACKNO'NLEDGEMENT OF CONDITIONS <br />W <br />H <br />� <br />� <br />O <br />� <br />� <br />� <br />a <br />ihc unAerc,�n@d,owner/applicant hereby agrees to hold and save harm� <br />less the City o( Everett from any antl all claims tor damages. costs. <br />e.penses. or causes ol action that may anse because of ins�allaUon <br />and maiNenance ol �he impfOvement or other right-Ol�Way use herel0 <br />appher: for and furiher ao•ees to remove same upon notice from the <br />C�!y ind Io repl. public p nerty damaged thereby. <br />�-8--��� <br />Si atur� o pphcant Date <br />WORK AUTHORIZED RY THIS PERMIT MUST BE STARTED WITHIN <br />�HO DAYS OF DATE PERtA�T IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY Bf <br />CANCELLED BY THE C�TY UPON ANV STOPPAGE OP WORK ON TN \ <br />PROJECT OVER 90 DAYS DURATION. �� <br />