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pate�139195 <br />PUBLIC <br />Print or Type Only <br />Johnston, Sack 6 <br />• <br />N <br />Applicalion faor <br />CJ <br />WOR� <br />� <br />d <br />3320 F e <br />i\ladim U <br />Y - 3s-z�-�- <br />PERM4� POSTING A�c � <br />rJ O V Y/ V� <br />������ <br />M M <br />�1 Everett <br />�Sm�L C� <br />L.E. Noblitt 659-5419 � �"� � � <br />Applicant M:;�I�nn Address Gty Zip Phone <br />Puo�m Worhs Permil • • � �� / <br />e�ne oeo� • 49348 <br />1e55 400�� �?e PaiO S! <br />8� I Bfll�lllCO �YC J� <br />� N <br />s25� 2347 <br />W y 7_ip Ph�nr. <br />� .� <br />s�� <br />G� <br />Descri6e Proposed Work <br />New house <br />Project Address lil knownl ___ 5021 Harbor Ln ____ <br />Attaeh four (4) eoP�es of nlans b� N�n�sed work - Drav: to •�:atr, .inn nole �he tollowmg as anUhr.ab�e�. <br />• Property Lines <br />• Outlme and dlmensions ol all existing and <br />proposed slrucWres on Ihe lot <br />• Existing ard proposed utilities <br />• Gen�crlinr nf s�reel <br />• Indicate Norlh <br />• Show any pronosed gratlinp r.hanges <br />• Show measurements <br />PERMITCONDITIONS <br />1. All calls for inspection shall be made 24 hrs. in advance- phane 259•8810. <br />2. All work shall be peAormed in accordance with ihis permit and current City of Everett Design and Construction <br />Standards and Specitications. <br />3. Call Location Underground Service 4B hrs, before you dig. TOLL FREE NUMBER 1-800•424•5555. <br />�, 5; �1�y��%,' <br />.� ����f .S� �� <br />2s ��e-�� S-�� �(z� �, <br />✓'v�-� c~�{ � G (� <br />�� ���,r.�� �«. <br />C'"ur1 fzic f f�4J /i? �«�,r G� >3�-�I4o3 �ari�i� ��v <br />n� ti 1C ,� J c ��� ��e� E; u� . <br />'��PUBLICWORKSDEPARTMENT <br />3200 Cedar Sireet <br />Everett. WA 98201 <br />Phone:259-8810 <br />ACKNOWLEDG[A1ENT OF CONDITIONS <br />W <br />H <br />� <br />� <br />� <br />� <br />� <br />� <br />a <br />the unAersinned o•.vne�/applicant nereby agrees to hold and save harm� <br />tess the Gry of Everett Irom any . nd all claims foi damageti. r,osls. <br />eKpenses. or ��uses ol action that may arise because ol installation <br />anA maintenanr.e o! Ihe improvement or other nght-ol�way use hereio <br />appi�ed for and Iwiher agrees lo remove same upon notice irom Ihe <br />C�'y ,�nd to replace puULc proneriy damaged thereby. <br />Signatw plic t Date <br />WORK AU hi ED BY THIS PERMIT MUST BE STARTED WITHIN <br />190 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />8E DILIGENiL1' PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PRO.IECT OVER 90 DAYS DURATION. <br />