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PUBLICGORKS PERMIT <br />TYPE OF, PRINT ONLY <br />Applicant <br />Describe Proposed Work _ <br />PROJECT ADDRESS (if known) <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 90201 259-8810 <br />DC <br />Public Works Permit R <br />Building Permit e <br />Public Works Fee <br />Plan Check No: B 62199 SEPA <br />Applicat.Datet 04/16 99 Phone <br />Addrst 4806 AN AVE <br />Ownert DIMARCO NAT <br />Tenantt <br />Proposed Use: GARAGE <br />Daso. of Mork: Phone <br />MEN DETACHED GARAGE <br />OFFICE SET JOB SET <br />APPRVD FOR PERMIT: DATE_/_/_ BY <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the following 0 applicable: <br />Property Lines "Outline and dimensions of all existing and proposed structures on the lot 'Existing and proposed utilities <br />"Centedine of street "indicate North @Show any proposed grading changes "Show rnsasuremsnts <br />PERMIT CONDITIONS: <br />1. All calls for inspection shall be made 24 hours In advance - phone 259-8810. <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 Locetion Underground Service 48 hra. before you dig. TOLL FREE NUMBER 1-800-424-55M <br />PUBLIC WORKS P Ptarr <br />NOT AEOUIPE► <br />4Y— — <br />_ <br />HATE ---�_ <br />4is:� Gxuilr� l�� <br />Approved for Construction Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />W <br />ca <br />0 <br />90) <br />0 <br />0 <br />a <br />ACKNOWLEDaEMENTOFCONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and am harmless <br />the City of Everett from any and all claims for damages, costs, expenses, or <br />causes of action that may arise because of installation and maintenance of <br />the hnprovement or other right-of-way use hereto applied for and further agrees <br />to remove same upon notice from the City and to replace public prop" <br />damaged thereby. <br />Signature of Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER 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 />