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Date 7-12-91 <br />Application For <br />PUBLIC WORKS PERMIT <br />Pdrit or Type Only <br />Brandon L. King 2406 Hillside Lane Everett 98203 <br />Mailing Address City Yip <br />Pubic Works Permit <br />Bldg. DOW. a 91/27319 <br />Public Works Fee b, <br />Total Fee <br />Less APPL Fee Paid S <br />9slame Due $ <br />353-3762 <br />Phone <br />Owner <br />Mang Address City Zip Phone <br />Applicant <br />Describe Proposed Work Carport Addition <br />Project Address (If known) 2406 Hillside Lane <br />Attach four (4) copies of plans for proposed work • Draw to scale and note the following as applicable: <br />• Property Lines • Centerline of street <br />• Outline and dimensions of all existing and • Indicate North <br />proposed structures on the lot • Show any proposed grading changes <br />• Existing and proposed utilities • Show measurements <br />_ PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 his. 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 48 hrs. before you dig. TOLL FREE NUMBER 1.800.424.5555. <br />1 �_ sew /D� ,ten �/1��, <br />— �Q <br />rCl <br />— <br />i <br />,, <br />,(11is <br />1. <br />Construction <br />Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />Phone: 259 8810 <br />W <br />H <br />Cl) <br />M <br />0 <br />in <br />z <br />0 <br />Cl) <br />0 <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the City of Everett from any and all claims for damages, costs. <br />expenses, or causes of action that may arise because of installation <br />and maintenance of the improvement or other right-of-way use hereto <br />applied for and further agrees to remove same upon notice from the <br />City and to replace public property damaged thereby. <br />Signature of Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED 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 />