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�. <br />Jate 4/18/95 <br />PUBLIC <br />Print or Type Only <br />�le Blank <br />Applicant <br />Application Fo� <br />WORK� <br />a. <br />0 <br />� <br />1 <br />o� <br />PO Bvx <br />New house <br />Describe Proposed Work ___ <br />Project Address (if known) <br />Te POSTING 7"i 3"S5 <br />PERMIT <br />� i' c� Ci O o 0 6 C_� <br />v� �S� f'_� f,J v] O G� r.� G� <br />.rrir�ci�o o,utn <br />U .O �u .�. +n r; [�� o� r:i <br />p^ Hf VA tll bt M f\: CJ <br />2�,6$ Everet3 9��3 <br />es � r� __ <br />�y. p,. ...t r?Ym I> .. <br />O rn Ln = r_7 1' � n W q �� <br />O t'� Ui L� f> f� �-� O i W LLI <br />O I J I�J J i1' [k [J lJ } f <br />�.,. i1'i 0.]= W U) O YG U) 4) [� <br />ess Ciry <br />Basic 293 <br />Pu01ic Worxa Permlt� / J �O <br />BIE9. UePt. r __ <br />Puel¢ WorF� Fee <br />Totai Fee f <br />Less AoO� Fea PaiC S <br />Babnce Due S Z��- <br />355-9725 <br />Zip <br />Zip <br />Attach four (4) coU�es of plans for proposetl work - Draw to scale and nole the following as applicable: <br />• Property Lines <br />• OuUine emd dimensions ot a�l existing and <br />propoSeC structures on the lot <br />• Existing and proposed utilities <br />� Centerline of street <br />• Indicale Norih <br />• Show any proposed g�ading chanqes <br />• Show measurement� <br />PERMIT CONDITIONS <br />7. All calls for inspection shell be mede 24 hrs. in advance- phone 259�8810. <br />2. AII work ahell be perfortned in accordence with this permit and curtent City of Everett Design and Construction <br />Stenderds and Specifications. <br />3. Call Location l�naerground Service 48 hrs, before you dig, TOLL FREE NUMBER 1-800�424•5555. <br />� <br />Construction <br />Approved as Constructed <br />S <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />� <br />� <br />� <br />� <br />O <br />� <br />� <br />O <br />a <br />The undersignetl owneVapplicant hereby agrees to hold and save harm� <br />less tha CRy ol Everett from any antl all claims for tlamages, costs, <br />eapenses. or causes of aclion that may arise becausr. of instal4d�on <br />and maintenance ol Ihe improvement or other righFof•way ure heieto <br />applied for and further agrees to remove same upo.� no�ir,e Irom fhe <br />Cily ai re a public property damaged thereby. <br />/� L ��ii�/� �/�/.i/i` <br />.ia�e <br />PUBLIC WORKS DEPARTMENT W AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />3200CedarStreet 1 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />Everett, WA g8201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />Phone: 259-8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />