2804 GRAND AVE EVERETT PUBLIC MARKET 2018-01-02 MF Import

APPLICATION FOR PUBLIC WORKS PERMIT Typo or print clearly with Ink PRESS HARD - YOU ARE MAKING COPIES PERMIT NO. PUBLIC WORKS EVERETT. WASHINGTON BLDG. DEPT. NO. ❑ OWNER AGENT DATE n2 C, /J APPLICANT/FIRM�REPREESENTED ADDRESS A2_G,V� 4J—,e14&Z2 CITY �U�C TELEPHONE '25 6,V HEREBY APPLIES FOR PEPM,;iSSION TO LJSf Tf/2=;_ 67/o9,=_- d 4L/ — //-) E�_Z' AT THE FOLLOWING LOCATION � AAEF �� e-Ae 4"� Attach five (5) copies of preliminary plans for proposed work Draw to scale and show the following as applicable: • Property lines and street identity. • Topographic changes requiring cuts and fills • Outline and dimensions of existing and other than normal foundation. proposed structures. • On -site drainage systems when required. • Existing and proposed utilities. • Erosion control methods when required. • Centerline of abutting right of way. • North arrow $i rwturs o1 Applicant PUBLIC WORKS PERMIT CONDITIONS; 'Selling of produce does not require a permit from the Snohomish .Health District. Contact the Department of Agriculture office, Verne Hedlund, Olympia, 753-5043. Ken DeLeone • .... ..... al Health Specialist C �j ll D ...... , ..... JUli 141982 CITY OF EVERET I . , . . . . . . . . . pi,t,,c. storks D . . , _ The undersigned owner hereby agrees to hold and Save harmless I the City of Everett from any and sit claims for dameg" costs, I expenses. or causes of action that may ■ri" becauee of Installation i and maintenance of the Improvement or other rlgM•of•way use • hereto applied for and !usher agrees to remove Same upon notice from the City and to replace public property damaged thereby. APPROVED FOR CONSTRUCTION DATE APPROVED AS CONSTRUCTED DATE PERMIT IS VALID FOR 1 YEAR EXPIRATION ACKNOWLEDGEMENT OF CONDITIONS SIGNATURE OF APPLICANT DATE POST ON I CALL FOR INSPECTION POST 259.8811 24 H RS. BEFORE CONSTRUCTION