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� Y - �- z� -,� 5 <br />Date-1L=19-93 <br />Application Fori� To pOS�`�G ��V �� <br />PUBLIC WORK�PERMIT <br />x 638$85i8� 8 88� <br />Print or T e Onl y�g <br />YP Y �i67Cw'��� `� w�� <br />"' n t- o `.�' <br />Martin Robinett (M2JD Holc <br />er MeiNng <br />Mallard Homes Corp <br />Applicant <br />Describe Proposed Work <br />Mailing Address <br />nex house <br />Project Address (il known) J-1� <br />Ciry Zip <br />�j-� , <br />,, <br />PuEllc Worka Vermit e �l7,S� 7 <br />eieo. oeo�. • 42653 <br />Pub��c Workf FRe <br />Totol Fee � <br />Lesa �ppl Fee P�IE S <br />Balante �ue i �D^ <br />1 259-9000 <br />Attach lour (4) copies of plans for proposed work - Draw to scale antl note the lollowing as applicable: <br />• Property Linae • Centeriine of street <br />� Outline and dimensions of all existing and • Indicate North <br />proposed structures on the lo! • Show any proposed grading chenges <br />• Eziating ar.d proposed utilities • Show measurements <br />PERMIT CONDITIONS <br />1. All celts for inapection shall be mede 24 hrs. In edvance - phone 259�8610. <br />2. All worlc shall be parfortned in accordance with thia permit end curtent City of Everett Dealgn and Conetructlon <br />Stendards and Speclficetlona <br />3. Cell Locatlon Underpround Service 48 hre. before you dig TOLL FREE NUMP�A 1-800�4245555. <br />�{� Gonpcl� cio�v,nspoutis •to slcbse.,� <br />�, Ptr� dr�vG w�t,y �rom ed9e o{ Pavc.r+�en� ;n s4az�� ko Proper{x� L�he. <br />Z3 `� <br />Date <br />/a -r- <br />FINAL INSPECTION <br />Approved as Constructed <br />�PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everelt, WA 98201 <br />Phone: 259•8810 <br />DAt� <br />W <br />� <br />� <br />� <br />O <br />� <br />� <br />O <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned ownei/applicant hereby agrees to hold and save herm- <br />less the City of Everett Irom any and all claims tor damages, coats. <br />expenses, or causos of action that may arise because of installation <br />and maintenance of the improvement or other right-of•way use he�eto <br />applied for and further agrees to remove same upon notice I�om the <br />City and to replace public property demaged thereby. <br />^��(' fc�'�_.�— /'ao �j'`� <br />� nature of Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />1B0 DAYS OF DATE PERMIT IS ISSUED AND THEHEAFTER IS TO <br />BE DILIGENTLY PURSUED T'� COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />