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1 <br /> Applicalion For <br /> � PUBLIC UVORKS PERMIT Daie <br /> PUBLIC WORKS DEPARTMENT Public Works Pertnit A <br /> 3200 Cedar Street <br /> Everett,WA 98201 259-8810 Building Pertnit N <br /> TYPE OR PRINT ONLY Public Nbrks Fee S <br /> Plan Check No: B 52904 SEPA <br /> Applicat.Date: 09/18 96 <br /> Owner Job Addreae: 616 P CKS DR Phone <br /> Owner: EVERETT SCHOOL DISTRICT <br /> Tenant: MHDISON ELEM <br /> Propoeed Uee: SCHOOL <br /> qppp�� Deec. of Work: Phone <br /> RELOCATE PORTABLE <br /> D6SCrib9 PfOE)OSBf�WOfI(_ pFFICE SET JOB SET � <br /> APPROVED FOR PERMIT: DATE_/_/_ gY � <br /> � <br /> � <br /> PROJECT ADDRESS(if known) M <br /> Attach four(4)copies oi plans tor proposed work-Draw to scale and note the following if applicable: �+� <br /> •Property Lines 'Outline and dimenslons of all existing and proposed structures on the lot •Existing and proposed utilities O <br /> �Centerline of street •Indicate North 5how any proposed grading changes •Show measurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS: Z <br /> 1.All calls for inspection shall be made 24 hours in advance- phone 259-8810. O <br /> 2.All work shall be performed in accordance with this permit and current City of Everett Design and <br /> Construction Standards and Specifications. <br /> 3. Call Locatfon Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. H <br /> �/1 <br /> O <br /> a <br /> 'URUC uvORi<S �EFlµ11 <br /> �'!O� REpUIR61P <br /> �y /lF5 <br /> �'�TE- —S'--za/ 9C. . <br /> 7.. <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The unCersigned owner/applicant hereby agrees to hold and save harmiess <br /> the City of Everett from any and all claims for damages,costs,expenses,or <br /> Approved for Constructlon Date causes of action that may arise because of Installation and maintenance of <br /> the improvement or other righ4of-way use hereto applied tor and IuAher agrees <br /> to remove same upon notice from the City and to replace public property <br /> damaged thereby. <br /> FINAL INSPECTION Date <br /> Approved as Constructed <br /> Signature of Applicant Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEFEAFfER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLETION.THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />