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J <br /> ���i <br /> Hp� <br /> Q 1-� <br /> H��MC <br /> ��'III---+tl��� <br /> y y� Date 8-5-91 <br /> x ", <br /> f"� Publl[WOd!Pa�mi�• <br /> �O� Applicalion For eiae-oeoi.• 91/27487 <br /> ��g PUBLIC WORKS PERMIT Pu�TotafoaFee S <br /> �� O LeseAoo�FoePeiC g <br /> s y� Print or Type Only a.m��o a�a s <br /> t� <br /> HH <br /> tA <br /> H <br /> ��M Mark A. Reeves 2327 Oakes Ave Everett 98201 252-6375 <br /> � Owner Mailing Address City Zip Phone <br /> H O V�i Owner <br /> � Applicant Mailing Address City Zip Phone <br /> Describe Proposed Work convert post foundation to conerete <br /> W <br /> ProjeC�AddresS(if known) � <br /> Altach four(4)copies ot plans for proposed work- Draw lo scale and note ihe lollowing as applica6le: � <br /> • Properry Lines • Cenlerline of street /A <br /> • Outline and dimensions of all exisling and • Indicate North V� . <br /> proposed structures on the lot • Show any pmposed grading changes <br /> '�t • Eaisting and proposed utilities • Show measurements � <br /> ' ' 00 NOT WRITE BELOW THIS LINE <br /> PERMITCONDITIONS O <br /> '�' 1.All calls for inspection shall�e made 24 hrs.in advance•phone 259•8810. � <br /> 2.All work shall be peAormed in accordance with lhis permit and current Ciy�of Everelt Design and Construction <br /> ' ' Standards and Specilications. <br /> � 3.Call Location Underground Service 4B hrs.6efore you dig.TOLL FREE NUMBER 1•800•424•5555. � <br /> ' <br /> ' ��<-;i-c Ctict���i-f�i�.,..f����f�u«.t� O <br /> � � <br /> _ � Y/ <br /> �_� B � 9-yi <br /> � Q <br /> � a <br /> ►- <br /> �' ACKNOWLEDGEMENT OF CONDITION� <br /> ' � - The undersigned owner/applicaN hereby agrees to hold and save horm- <br /> less the Ciry ol Everetl Irom any and all claims lor dama9es, costs, <br /> expenses, ur causes of atlion ihat may arise hecause of installatioi� <br /> and maintenance of the improvement or other righ4ol-way use hereto � <br /> �pplied tor and luriher agrees to remove sacie upon nohce Irom ihe <br /> Approved for Construction Date Cily and to rep�ace public property ti...na9ed thereby. <br /> FINAL INSPECTION Date <br /> Approved as Consfruc�ed Signalure of Applicant Date <br /> � PUBLIC WORKSDEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STAFiTED \'lITHIN <br /> 3200CetlarSireel 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett,WA 96201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAV BE <br /> Phone:259�8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DUFATION. <br />