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Date <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Owne� <br />AOPlicant <br />Pl�n Check No: B 37573 SEPA <br />Ap}�licat.Date: 07/30/92 <br />Job Ad�ner: PATTENACHARLESW&LLYNN <br />Tenant: <br />Proposed Use: CARPOAT/SFR <br />Desc. of work: <br />CAAPORT <br />DPscribe Proposed Work _ OFFICE SET JOB SET�� <br />APPAOVED FOR PEAMIT: DATE_/_/_ BY <br />Proiect AdCress (il ::nown) <br />P�o, � wo,�, ��,m„ . <br />eiao oeW • _ <br />PuoiicWOIXiFee S <br />Toial Fee <br />less ADO� Fce Pn0 S <br />Bala�caDue S <br />Attach four (4) �oPies o! plans lor prcposed work - Draw lo scale and note� Ceote line of streeit able� <br />• Property LineS • Indicate Norlh <br />• Outline anA^dimensions ol all existing and -� Show any proposed grading changes <br />prcposed sliuctures on ihe�lol • Sho++ mezsuremenls <br />• Ezisting and proposed utilities <br />Phone <br />PERMIT CONDITIOh3 <br />1. All calis for inspection shall be made 24 hrs. in advance - phone 259-8810. , <br />2. All work shall be pedormed in accordance with this permit and curreN Gry oi Everett Design and ConsWction <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800-424•5555. <br />I � / �j ,�t /� ^ %// <br />, / W`„ti (��U"�e �_/2m ^ � /!/Cl /lV4 c.<i .�.,� <br />. I �_� � � <br />A 3 —9 z <br />Approved lor Constru^.tion <br />Date <br />FINAL INSPECTION Dale <br />Approved as GonslrudeA <br />�PUDLIC WORKS DEPA9TMENi <br />3200 CeEar Street <br />Everel4 WA 98201 <br />Phone: 259�8870 <br />� <br />O <br />� <br />� <br />� <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/apP�icant hereby agrees to hold and save harm• <br />less the Cily ol Everett irom any anJ all claims lor damages, costs. <br />eKpenses. or causes ol action that may arise because of installation <br />and maintenance ol ihe improvement oi olher right-ol�way use hereto <br />applied �or and lurther agrees to remove same upon nolice Irom ihe <br />City and to replace public proPerty damaged thereby. <br />Signalurc of App�icant Dale <br />WORK AUTHORIZED BY THIS PERMIT MUST BE 'iTARTED WITHIN <br />i80 DAYS OF DATE PERMIT IS ISSUED .4N0 THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAV BE <br />CANCELIED BY TI1E CITY UPON ANY STOPPAGE OF WORK ON THIS <br />NNOJECT OVEF 90 DA'fS DURATION. <br />