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Date 9-13-95 `�q �OSTING AUG 0 4 19:, <br />. Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Pu1�Lc1Vo�FSPnrmi�� 9S y�� <br />em� o�o+ • 49471 <br />PuliLc lyorks Fe0 <br />ioial �ce S <br />LCSS 4p01 for P�q� S�_�� <br />e.,i.,��,. o„� S 2�in.� <br />George Hawkinson 243 Elm St 11204 Everett 98203 259-3448 <br />Ownei \1a�linq ACdress � �. Cn.' , . -�.Zin phonc <br />Owner <br />AppliGan[ F.^. In�c; ,1 ddi rs s—�-� —�- -� --- ---- <br />Describe Proposed Work driveway <br />Project Address (il knownl 616 Olympic Blvd ___ <br />�i� --� �-- -- o�-an� <br />Attach lour (4) copies of plans loi uropused work - Drav: to ,cai�• .,;,n n�.te m�a foilowing as anuhr;�hie, <br />• Property Lines • Cunteihnc n! Street <br />• Out6ne antl dimension5 0l all exi5iing and • Indicate Norlh <br />proposed structures on U�e lot • 5hoa� any r,roposed yrarin9 chanues <br />• ExiSting and proposed utilities • Shnw mea5urement5 <br />uv rvvi YVHnt CtLUW IHIS LINE <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hrs. in advance • phone 259•8810. <br />2. All work shell be performed in accordance with �his permit and current City of Everett Design and Construclion <br />Standards and Specifications. <br />3. Call Loc2tion Underground Service 48 hrs. before � ou dig. TOLL FREE NUMBER 1-800•424-5555. <br />L /� • <br />. /C.Ph�oz.� �Sl'u,y <br />C��,�.6 �,��fi yr'�.LP hi. <br />J2��ccui� �'.2e�a-�t<.a� .c�ioP � <br />� Cu�b ,r1e�i c.�.��, s�•� d�,.►.�.._ <br />✓`, e��.l� �tu�� �u.�u.u� �,�, � <br />'�e 4,� o .� �:,f � -� <br />L�L �Z S <br />��`.��.�- --���s_ <br />Approved lor nstruction Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />Phone:259-8810 <br />3o i <br />W <br />� <br />� <br />� <br />� <br />�7 <br />cl r��-� �.�.�c< /'� O <br />Cl C'c'Otit..� �I� lti � �' / � <br />/ G-- <br />ACKNI�WLED�NT OF CONDITIONS//�( <br />The �.mdersiqned ownei/appliCant hercUy agrees to hold antl save harm� <br />� less the Cdy ot Everett from any and all claims for Aamages. cosis <br />� eq>enses. or causes of action Ihat may arise because ol mstallaM1on <br />' nnA ma�nten2nce-T! Ihe improeement or other nght�of�way use hereto <br />� apphed for anA�liirther aqrees remove samn upon notice irom Ihe <br />�' Gh� ar,d to repl,a public rty maged thereby_ <br />� r<<l ,��C� y!�ti �� q s <br />iSiqnature of Ap ican! y�� <br />INORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />I 1A0 DAYS OF DATE PERMIT IS ISSUED AND THERFAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAV BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF VJORK ON THIg <br />I PROJECT OVER 90 DAVS DURATION. <br />