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c <br />, <br />Date June ll, 1993 F`' _ <br />� S!� A-i.� <br />Appllcatlon For <br />PUBLIC WORKS PERMIT <br />f:. i'. �... <br />Print or Type Only "^i r� ti � �,� °, � <br />'- Jj <br />- n .-_ ti ..: - .-r ' <br />' t- . • _ ,. <br />' r.� ._ : � •:� `i� ... :. <br />� <br />, _ <br />Houstng Authority of the ccr.,''s.o. �.:___.%.� ._ `; ' f; •' <br />CNJJ Architects 2722 <br />APPlica rt <br />Describe Proposed Work <br />including: Dam <br />new ramp with <br />Also included: <br />'ro(ect Attl�iess (if known) <br />-- o.._...�.,, <br />.. . <br />Ib�, Suite �607 <br />Mailing Address �—' <br />sidewalk replaceme <br />s to <br />dra <br />I Pv011c Work� Permlt • • �+ �� '.. <br />IBIEp. OePI • . , <br />WOIk Worka Fee <br />Total Fee S <br />�caa AOVL Fee P�ia S <br />c. i. <br />Baiance Due' ' � s �S ��—� : <br />�OZ-32ZS�o%7'B,�/ <br />,=; �� - <br />c�tr ,-, - <br />. .; . , ., � _ . Zip . � Phone _ <br />_ �. ... - . .�� - � � <br />,.e...,.. ���. ---- <br />curb <br />R <br />., <br />� <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the following as applicable: <br />• Property Lines <br />• Outline and dimensions of all existing and � Centerline ol street <br />proposed structures on the lot •��dicate North <br />• Existing and proposed uttlities • Show any proposed grading changes <br />• Show measurements <br />PERMIT CONDITIONS <br />7. All calls for Inapection shall be made 24 hrs. in advance - phone 259-8810. <br />2. All work shall be performed in accordance with this permit and current Cify of Everett Design and Construction <br />Standards and Specificattona <br />3. Call Location Underground Service 48 hra before you dig. TOLL FpEE NUMBER 1-$00-QQ4-5555. <br />%� P'�i �Pa�.� a�ycy,,,.�/ 6� f,u.l�i �� or„ 7-�9-�'� <br />���� <br />l� i3' �@!M� T i� i/lA��PC� lI/`/�/� <br />Z Cp - �� �1 � <br />rove��e struction 6 <br />Dale <br />FINAL INSPECTION <br />Appraved as Constructed Date <br />�PUBLIC WORKS DEPARTMENi <br />3200 Cedar Street <br />Everett. WA 98201 <br />Phone:259-8810 <br />W <br />H <br />� <br />� <br />� <br />O <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and s:,ve harm• <br />less the City of Everett lrom any and all claims lor damages, costs, <br />expenses, or causes of action that may arise because of installation <br />and maintenance of the improvement or other right-of-way use hereto <br />applied lor and further agrees to remove same upon notice irom the <br />City and to replace public property damaged thereby. <br />6-17-93 <br />ignature ofAppii n� ' Date <br />WORK AUTHORIZED BY THIS PERMI7 MUS7 BE STARiED WITHIN <br />1B0 DAYS OF DATE PERMIT IS ISSUED AN� THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CI7Y UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECi OVER 90 DAYS DURATION. <br />