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Date 11/25/92 <br />PUBLIC <br />Tp FUStING ��u �- <br />Application �or <br />WORKS PERMIT <br />�.� <br />� . . r, ..� �- c� <br />Print or Type Only ' �� � .,,._' <br />, � � ;., ,_ <br />�i _ _ <br />. , �,, <br />Robert J WiKheies 21fi11 45th.Ave S$ <br />oW�e� � , � :, nnux� naa�gs� , , <br />� � �" l�l <br />,�„ , <br />i ,. � i �.i i��` <br />Bob Withere ' �ame " " � � ' <br />PuElicWorksPi�rmit• �� � /� <br />eiea oan� • 38835 <br />Pu01k W>rks Fee <br />Tot�l Fee s <br />leas �oo� Fss P�10 STyv�� <br />P�lance Due f H l <br />Bothell 98021 481-4594 <br />ary <br />rnone <br />Applicent Mailing 4ddress City Zip Phone <br />Describe Proposed Work New house Basic <br />Projecl Address (if known) <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the following as applicable: <br />• Property Llnes <br />• Outline end dimensions of all ezisting antl <br />proposed structures on the lol <br />• Existind and proposed utilitiea <br />• Centerline ol street <br />• Indicete North <br />• Show any proposed grading chenges <br />• Show measurements <br />PERMIT CONDITIONS <br />1. All calln for inapection shall be made 24 hra In edvance • phona 259�8810. <br />2. All work ahall be peAormed in accordence with this permit end current City of Everett Deaipn and Construction <br />Stanaarde and Specificatlona <br />3. Call Lacation Underground Service 48 hra before you dig. TOLL FREE NUMBER 1•800�42455�5. <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Streel <br />Everett, WA 98201 <br />Phone: 259•8810 <br />ACKN��WLEDGEMENT OF CONDITIONS <br />W <br />H <br />� <br />The untlersigned owner/applicant hereby agrees to hold and save harm- <br />less the Ciry oi Everett from any and al� claims for dameges, coata <br />expenses, or causes of ection that may erise becausa of instellation <br />and maintenance of the improvement or other right-of•way use hereto <br />appl' for a furt er agree to remove same upon notice irom the <br />C' an to r ce ublic pr rt damaged thereby. <br />�Z r�-�'Z <br />Si9n ure of Ap cant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />1b0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PUFSUED TO COMPI_ETION. THIS PERMIT MAY BE <br />CP,NCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />