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Dat@ — , Pu01ic WorMt Permlt• <br /> Application For eiao.oeo�.• <br /> PUBLIC WORKS PERIV�IT P°°To„FeeFee s <br /> Lam Aoo�Fee Peia S <br /> Pfiflt Of Type Only Plan Check No: C 45895 SEPA a,ia�c.o�e S <br /> Applicat.Date: 10/19/94 <br /> Job Addrs: 3412 NOATON AVE (B) <br /> Owner: HAMPTON RICK <br /> Tenant: <br /> Proposed Uee: SINGLE FAMILY RESIDENCE <br /> Owner Desc. af Work: rip Phone <br /> ADD ON STORAGE SPACE - � <br /> Applicant OFFICE SET JOB SET <br /> -�P Phone <br /> APPRVD FOR PERMIT: DATE_/_/_ BY <br /> Describe Proposed Work _ <br /> W <br /> Project Address(if known) � <br /> Attach four(4)copies ol plans for proposed work• Draw to sca�e and note ihe following as applicable: � <br /> • Property Lines • Centerline of sireet � <br /> • Outline and dimensions of all ezisting antl • Indicale North <br /> proposed structures on the lot • Show any pruposed grading changes <br /> • Existing and proposed utilities � Show measurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMITCONDITIONS O <br /> 1.All calls for inspection shell be made 24 hrs.in advance-phone 259•8810. � <br /> 2.All work shall be periormed in accordance with this permit and current City of Everett Desfgn and Construction <br /> Stendards and Specificationa <br /> 3.Call Location Underground Service 4B hrs.before you dig.TOLL FREE NUMBER 1-$00-424•5555. � <br /> O <br /> . tIBLIG WORKS PEP.MfT � <br /> Nr,i REOUIREN � <br /> AY O <br /> �+ATF. !U o �'S�— <br /> a <br /> ACKNUWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm- <br /> less the City ol Everett Irom any and all ciaims lor damages, costs, <br /> ezpenses, or causes of action thal may arise because of instatlation <br /> and maintenance of the improvement or other right•of•way use hereto <br /> applied tor and �urther agrees to remove same upon notice iram the <br /> Approved for Construction Date City and to rep�ace public property damaged thereby. <br /> FINAL INSPECTION Date <br /> Approved as Co�structed Signature of Applicant Date <br /> PUBLIC WORKS DEPARTMENT WORK AUTHORI2ED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200CederStreet 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTEH IS TO <br /> Everett,WA98201 BE DILIGENTLY PURSUED TO COMPLETION.THiS PEP!�n1T MAti' BE <br /> Phone:259-8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />