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� <br />TYPE OF; PRIM ONLY <br />.'.•lication For <br />PUBLIC VrJRKS PERMIT <br />PUBUC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 259-8010 <br />� <br />Date 4/9/97 <br />Public Works Pertnit N <br />Building Pertnil # <br />Public Works Fee S <br />PROJECT ADDRESS (if known) <br />42Q�t QBS�AN R�- <br />Atlech four (4) coPies ot pians for proposed work - Draw to scale and note the iollowing it appiicable <br />d roposed structures on the lot <br />•Existing and proposed utilities <br />•propeRy Llnes 'Outline and dimensions of all ezisting an P 5� rading changes •Show measuremenls <br />�Centerline of street •Indicate North 5how any propo A <br />..,..�.,T ���oirG FtFI OW THIS LINE <br />PERMIT CONDITIONS: hone 259-8810. <br />1. All calls for inspection shall be made 24 hours in advance - p <br />2. All work shall be performed in accordance w�th this permit and current City of Everett Design and <br />Construction Standards and Spec�fications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-8�-424- • <br />� 0 t���� d2 U��lN��S <br />Date <br />qpproved tor Construction <br />FINAL INSPEGTION <br />Date <br />qpproved as Constructed <br />��,��n� I�I' T`���J��r�, <br />�'�'� <br />� <br />O <br />N <br />�a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to holdcaQns 5 ezpenseseor <br />the Cily of Everett from an a�rise becau esof i sta ation and maintenance ot <br />causes of action that may �i�forandfuitheragrees <br />theimprovementorotherright-of-wayusehereand to replace public propeM <br />to remove same upon notice from the City <br />damaged lhereby. <br />Date <br />Signature of Applicant <br />COMPLETION•RTM S PERMIT MAY BE CANCEB ED BY TNE CINIUPON ANY STOPPAGE OF WORK ON TFIIS PROJEC OVER 90 D�A SEDD�IL�TION.Y PURSUED TO <br />