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� <br />� <br />Date 11/18/83 <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />`�4 <br />Public Wo�ka Permit s`� / 2`� I <br />83/ 2 <br />Bleg. Doot. + <br />PublicWorksFea 1�+ � � <br />TalalFao s ��'' <br />�es! Appl Fea Paitl S <br />8alenca Due S � ' 0 � <br />David W. Dykeman 905 Grand Everett 96201 �59-1545 <br />Owner Mailing Address City Zip Phone <br />Same <br />Applicant Mailing Address City Zip Phone <br />Construct 11' x 17' additio� to existing carport <br />Describe Proposed Work <br />Pro�ect Address (if known) <br />905 Grand <br />Attach four (4) copies of plans Ior proposed work - Draw to scale and note lhe fol�owing as applicable: <br />• Property lines <br />• Outline and dimensions of all existing and <br />proposed structures on the lot <br />� Existing and proposed utilities <br />PERMIT CONDITIONS <br />• Centerline of street <br />• indicate North <br />• Show any proposed grading changes <br />• Show measurements <br />1. All calls for inspection shall be made 24 hra in advance • phone 259-881 5. <br />2. All work shell be peAormed in accordance with this permit and current City of Everett Design and Construction <br />Standards and Specifications. <br />3. Cali Location Underground Service 48 hrs. before you dig, TOIL FREE NUMBER 1•800•424-5555. <br />%d/'�3 <br />t.0 jr u� <br />'��— .?_�,1-� <br />— FINAL INSPECTION <br />Approved as Constructed <br />everett PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />� Everett, WA 98201 <br />Phone: 259-8815 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />� <br />� <br />� <br />O <br />� <br />� <br />O <br />a <br />The undersigned owner/applicant hereby agroes to hold and save harm• <br />less the Ciry ot Everett from any and all claims for damages, costs, <br />expenses, or causes of action that may arise because of installation <br />and maintenanr,e oi the improvement or other righhol•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 />��G'� j�.�, �-c�-,-t/ i��/ �8s' <br />Signature of Applicant ate <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGEN7L'! PURSUED TO COMPLETION. Thi1S PERMIT MAY BE <br />CANCELLED BY THE :ITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVEa 90 DAYS DURATION. <br />i � <br />L ' <br />