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�� <br />TYPE OF' PRINT ONLY <br />i` AppliC2tOnFoT OS:ING " �/��/ <br />PUBLlC WORKS PERMIT Date lz-z�-9s <br />Loren Dorrah <br />Owner <br />�, _ <br />PUBLIi.�. WORKS DEPARTMENT Public Works Permit M �O <br />�200 Cedar Street <br />Everet�}NA 98201 259-8810 Building Permit 8 50365 <br />0 <br />r_ vi� �� u u4.+gou�o o � <br />'+ o y ri-u o o.+ o,u o r.i Public Works Fee $� <br />�Y' CY� Ml � C�J CJIfJC�Jui� � � <br />M? • tl� et + �M W �J <br />2820 Linco�'A�ay Lynnc�d8 98037 7'87-6700 <br />Curt Johnson 337-47 <br />Mailiny A <br />Describe Proposed Work <br />PROJECT ADDRESS (if known) <br />> c, City � > <br />��c,,a, �x�� <br />2010 Hollow Dale P1 <br />Attach four (4) copies of plans for proposed �vork - Draw to scale and note the tollowing if applicable: <br />Lot 8 SP Ii1202-24-94 <br />'Property Unes 'Outline and dimensio�is of all existing and proposed structures on the lot •Existing and proposed utilities <br />•Cen�erline of street •Indicate North •Show any propost�d grading changes •Show measurements <br />PERMIT CONDITIONS: <br />1. All calls for inspection shall be made 24 hours in advance - phone 259-8810. <br />2. All work shall be pertormed in accordance with this permit and current City of Everett Design and <br />Construction Standards and Specifications. <br />3. Call ! ocation Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. <br />4. Pri� �.�vay �videning sli:ill be in confomiv�ce �vith city ofEvere[t stnnd�u•d plmi #307. <br />?. Roi dop nmoH�may be Jischarged onro splaFh blocke or into downspout iatiltration <br />+y,haus smd cL ivewxy �w�otT'ahould Ue eucouraged to iufilti•ale iulo }vfu+sy or Ituidacuped <br />�u . �s. <br />� <br />W <br />� <br />�� <br />V♦ <br />� <br />O <br />� <br />� <br />O <br />�/� <br />V♦ <br />O <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned ownedapplicant hereby agrees to hold and save harmless <br />the City of Everetl from any and all claims for damages, costs, expenses, or <br />causes of action that may arise because of installation and maintenance of <br />the fmprovement or other right-of•way use he2to applied for and fudher agrees <br />to remove same upon notice from the City and to replace public property <br />dama d thereby. <br />�,, �; -: l�� ,� � -, - -� <br />Signature of Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 780 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE OILIGENTLY PURSUED TO <br />COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />