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�ate�2�5 <br />�- Applicatl� For <br />PUBLIC WOFi�CS PERMIT <br />Q <br />Print or Type Only � � 8 <br />.p O �J <br />n x <br />N <br />Garv L Larson 4214 Granfl A� Everett 982( <br />[�..i'"'iS� <br />Address <br />Y� <br />City <br />Describe Proposed Work rock vall ranging from 3� to 8' <br />or <br />Vuol¢ Wo�ks Permlt • /D� / <br />eiea. oea�.• <br />Pubhc Works Fee s <br />Tolal Fee <br />Les� �DD� Fee PnE � <br />Ba1�nc�Dua S �Qo� <br />Oo Z- 3 2 ZY n/58 3/ <br />ProlectAddress�ifknown) "'•" "aa"u ""� <br />Attech four (4) copies of plans for proposed work - Draw to scale and note ihe following as applicable: <br />• PropertY Lines • Centerline oi street <br />• Outline and dimensions of all existing an0 • �ndicate NoAh <br />praposed structures on the lot • Show any proposed grading chenges <br />• Existing and proposed utilitiea • Show measurements <br />. PERMITCONDITIONS <br />' 1. All calls for inspection ahall be made 24 hra. in edvance • phone 259-8810. <br />� 2. All work shall be peAormed in accordance with this permit and current Ciry of Everett Desiqn end Construction <br />StendaWa end 3peclficetlone. <br />3. Cell Locetlon Underpround Service 48 hra. before you dig. TOLL FREE NUMBER 1-600�4245555. <br />u <br />Approved <br />, �.. � <br />7 C� f1� s7`�'ef3' eK 7� 6c .fP�� eLe4h oYr �ud 4n ci <br />C►'i/^1� 47� qCC �ii�,¢s , <br />S �Uo!-,/c /a 6e c�r7Ne �er Q��rdve���ah O�q¢ep� ,���95 <br />��y4�`�,���� <br />� <br />'s.� f '6 ' <br />FINAL INSPEGTION <br />Approved es Constructed <br />�PUBIIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />Phone: 259•8810 <br />Date <br />Date <br />W <br />H <br />� <br />� <br />� <br />O <br />� <br />� <br />O <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />7he undersigned owner/applicant hereby agrees to hold and save harm• <br />less the City of Everett irom any and all clalms for damages, costs, <br />expenses, or ceuses of action that may erise beceuse of installetion <br />and maintenence of ihe improvement or other right•of•way use hereto <br />applied for and further agrees to remove same upon notice irom the <br />City p1Sc7yo replace public property damaged thereby. <br />GJ�iK AUfHORIZED BY THIS PERMIT MUST BE STARTED NJITHIN <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 />♦ <br />