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date �6-12-95 <br />'•' �N►t t L `�, �1 <br />ia '�� <br />Application For ��;� ?OSTING �--- <br />PUBLIC WORKS I�RMIT <br />0(� <br />(,j � <br />Print or Type Only r_ r c��� n`c� �' <br />r� • <br />(�I '� . 1 T l�' G M� d] ICf,J <br />n .-+ �., .: , . .o- �d � <br />M i M I<� M <br />n <br />Clark Cooke 1908 W Mukilteo Blxd �vereEt 9820��_ <br />QWf1Cl <br />Owner <br />Describe Propased Work <br />MaJiny �NdreSS'.. .�: l;ii)4i% ?r C.i �? `Li7 <br />�'J CD fJ �) Cl J- . <br />p.J O G1 1 J �J !u' Ll (� 4�' 7_ CJ ` <br />�J I 1-.I IJ ic ie� - � t <br />p'I fY (1 1'i� W ii. I. U> O(, <br />PA:;ihnq Address <br />new houae <br />Pro�ect Address ;it known! 4916 Nichols Pl <br />City <br />/ <br />Pup��c Worhs Pnrmil • � �� <br />aien oeo� + �as8� <br />P�ilA�c WorMa Fqe s <br />Talal Fee — <br />LC55 �DOI FP.! PdW S_/� <br />g�d�CP ��p i �/ ` <br />n r^ + <br />R �pGF] <br />� f•': <br />u� M <br />7.1P Gi _. Plronc <br />W c'� <br />3 f� W <br />[W U1 C� <br />Zlp Phone -- <br />Attaeh four (4) eopies ot plans fo� nroposeJ work - Drav: t� s�.al�� ana ncte th�� fo�lowiny as apUhr,ab�e� <br />• Pronerty Lines <br />• Out6ne and dimensions of all existing and <br />proposed strucWres on the lot <br />• Ezisti�c� and proFosed u�ilities <br />• Centerline oi street <br />• Indicale Nor�h <br />• ghow any proposed gratlin9 r.hanye5 <br />• Show medsurements <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hrs. in advance • phone 259-8810. <br />2. AI� work shall be performed in accordance with this permit and current Ci�y of Everett Design and Construction <br />Slandards and Specifications. <br />3. Cali Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800-424-5555. <br />Approved as Constructed <br />�A�PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett. WA 98201 <br />Phone:259•8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />� <br />� <br />O <br />a <br />The undei�iqned owner/apphcant hereby agrees to hold and save harm� <br />less ihe Gry ot Everett Irom any and all claims for damages. cosls. <br />expenses. o� causes of action Ihat may aris� because of installation <br />and maintenance o! Ine miprovement or other nght-oi-way �ise hereto <br />appl�r.d lor and,lurther ac�rees to remove same upon notice Irom ihe <br />C�ty and to replaca pubhc property damaged thereby. <br />/ . . :' � i <br />� // i <br />. L(�I�� / ��. <br />S�9natwe of APPlicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED \NITHIN <br />180 DAYS OF D�TE PERMIT IS ISSUED AND THEREAFTER IS TO <br />9E DILIGENiLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITV UPON ANV STOPPAGF OF WORY.ON THIS <br />PROJECT OVER 90 DAVS DURATION. <br />