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�a�e Pu�lic Works Parmll• <br /> ApplicaHon For eie9.oco�.• <br /> PUBLIC WORKS PERMIT PueToleFeaFes S <br /> L<ea ApO�Pea PaiE S <br /> Print or Type Only BalcnceDue S <br /> Plan Check No: B 48046 <br /> Applicat.Date: 04/12/95 SEPA <br /> Owner Job Addre: 7124 OLYMPIC DR <br /> �wner: W}�,�R DALE Phone - <br /> PropoeednUee� GARAGE <br /> Desc, of Work: <br /> Applicant NEW GARAGE <br /> Phone <br /> Describe Proposed Work OFFICE SET-Jpg SET <br /> APPRVD FOR PERMIT: DATE_�_�_ BY <br /> P�oject Address(if known) � <br /> Attach four(4)copies of plans for proposetl work• Draw to scale and note the following as applicable: � <br /> • Property Lines • Centerline of sireet � <br /> • Outline and dimensions of alt existing and • Indicate North <br /> proposed structures on the Iot � Show any proposed grading changes <br /> • Existing and proposed utilities • Show measurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PER�11T CONDITIONS O <br /> 1.All calls for Inspeclion shall be made 24 hrs.in advance-�•hone 259•881 O. � <br /> 2.All work shell be peAormed in a�cordance with this permit and current City of Everett Design and Construction <br /> Stendards end Specificetions. <br /> 3.Call Lo:ation Undergraund Service 4B hrs.before you dig.TOLL�qEE NUMBER 1-$00-424•5555. � <br /> O <br /> ?UBUC WOAKS PEPAIIT � <br /> N ! REOUIRE� � <br /> ar g <br /> QATE 9 i3 `JS O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm� <br /> less the City of Everett trom any and all claims for damages, costs, <br /> expenses, or causes of action that may arise because of installation <br /> and mainlenance ot the improvement or other right-of-way use hereto <br /> - applied for and further agrees to remove same upon notice from the <br /> Approved lor Construction �a�e City and to repiace public properry damaged Ihereby. <br /> FINAL INSPECTION Date <br /> Approved as Consiructed Signature ol Applicant Date <br /> ���� PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200CedarS�reet 780 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett,WA 98201 6E DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone:253-8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WOqK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />