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Date 4-17-95 � � �„�,����•��,.:v..,�„�. - — <br /> Aot>lication Fnr ��n,i o,r� • _48081 --- <br /> PUBLIC WORKS PERMIT �°'�;o;;,FpE`°° s —_ <br /> Less 4on� fee Pnm 5 <br /> pabnce Cuu S <br /> Print or Type Only <br /> Everett School District 4730 Colby Ave Everett 98203 339-4350 <br /> Ownr.i Ma�4rn; 4r.dress l'.�t�' lif� Fhonc <br /> Finley Architects, Steve Butterfield 258-6471 <br /> qpplicant M.��I����:; Addi,•ss �-_-�-�- Citr Zin '_— Phone _--- <br /> one portable Madison Ble�entary <br /> OescribeProposedl4�ork ____. . -___._—_-.-..__-_-_ '- _.._____—._ <br /> _—_ —. ._. . ..._..-__ __—_— <br /> ---- -- ---- ----- ----- -- W <br /> Prolecl Address Id known! 616 Pecks Dr _ ______ __ _ __ _ __ _ � <br /> Attach four 141 coP�es of Ulans Ini ProP��s�'�l u�o•. � Drav: to��-.al��.u�.a nct�� tii�� 'uilotivin9 as aouhcnbie. � <br /> • Prpperty Lines • Ci�ntcrhnn nf sireN( � <br /> � Outime and Aimens�ons ol au exis?my and • ICCicaP: North <br /> proposed slrucWres on the lot • �ne�:any r.r000sed gratl�nry r.r,anu��s <br /> • Eaistin9 and proposed utillties • Show n`eaSUrzmPntS � <br /> DO NOi �:VRITE fiELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1.All calls for inspection shall be made 24 hrs.in advance•phone 259•8810. � <br /> 2.All work shall be performed in accordance with this permit and current City of Everett Design and Consiruction <br /> Standards and Specifications. <br /> 3.Call Location Underground Service 48 hrs.betore you dig.TOLL FREE NUMBF.R 1-800-424-5555. � <br /> O <br /> Mf �4�,� ��/� <br /> ��gL�W���Il1!!� V♦ <br /> ey B 9 ��_ O <br /> ��t� a <br /> ACKPlOC2LF�GEP.tENi OF CONDITIONS <br /> i h��u�+�f�-��iqned o�aner�npohcent hereby agrees to hold and savc harm- <br /> --� iess the Gity ot Eva�ett trom any anA all claims for dam,�9es. cosls. <br /> i e*penses o� causes of action that n:ay ans� hecause of msiallation <br /> , and maintenance n! itie :mprovement or other right-ol•way use heretn <br /> - ! aDP����: �or and turiher ;19rces �o remove samn upon natice ��om Ihe <br /> Approved for ConslrucUnn �'�+��' �I O'v .�nd to replaca uubhc pronerry Jamaged thereby. <br /> � <br /> — 1 <br /> FINAL INSPECTION Date ' _ <br /> Approved as Consiructed I Sipnalure ot Applican! Date <br /> �A�I�� PUBLIC WORKS DEPARTMENT I 11'ORK qUTHORIZED BY THIS FENMIT MUST BE STARTED WITHIN <br /> I 190 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200CedarSirect BE DILIGEIJTLI' PURSUcD TO COMPLETION. THIS PERMIT tdAY BE <br /> Everett,WA 98201 , GANCEILEU B'f THE CITY UPON FNY STOPPAGE OF WORK ON THIS <br /> Phone:259�8810 � PROJECT OVER 90 DAYS DUHATION. <br />