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Date 4-1-94 � F-�-Z�1_� <br />Application For <br />PUBLIC WORKS PEF��VIIT <br />F�' nOSTING / �i{f o <br />Print or Type Only ` o 0 0 0 0 0 0 <br />�!_ onooinn$o <br />u_ <br />ra o��+oo�o[io <br />U li 1 M M fR M N�I� N <br />Andrew Austin 9004 191st Pl SW Edmonds ,WA"� 9Rn�6 »i�aor <br />Owner <br />Describe Proposed Work neW <br />Maiting Atldress <br />Mailing Address <br />Lot 4 SP II <br />Project Address (if known) ��� �V �� � r�� <br />�. �n Gl�y x :i ., <br />� � <br />oc�cox �� �?.:-�� <br />OOGJU LlU) CiCe: ^ <br />a� a i rS a� °u5 ui n <br />Puplit N'orAs Permil � �%1�' _ <br />eiao. oeo�. • 43974 <br />Publ¢ Works Fee - <br />Tolal Fee S <br />Lesa Aoo� Fee Pe�O S <br />o?a�eo S f1T <br />O O G b � <br />[� Il] I!') IA O <br />� N � W .L—�i <br />� � <br />�i <br />��i�w <br />¢g.-�r_ <br />�.t�.�, <br />Attach four (4) copies ol plans for proposed work - Draw to scale and note tne following as applicable: <br />• Property Lines • Centerline of street <br />• Outline and dimensions of all existing and • Indicate North <br />proposed structures on the lot • Show any proposed grading changes <br />• Existing and proposed utilities • Show measurements <br />PERMITCONDITIONS <br />1. All calls for inspection shall be made 24 hrs. in advance - phone 259•ii810. <br />2. A�I work shall be performed in accordance with this permit and current City of Everett Design and Construction <br />Standards and Specifications. <br />3. Call Location Underground Service 4B hrs. before you dig. TOLI FREE NUMBER 1•$Op•424•5555. <br />Li� Connu.� Q-«� dv�il� s �+.�, -�o s�vrm drA�, q�e-s{v� <br />�vCd¢� � Lo�. <br />rINAL INSPECTION <br />Approved as Constructed <br />��PUBLIC WORKS DEPARTMENT <br />3200 Ceder Street <br />Everett. WA 98201 <br />Phone: 259-8810 <br />W <br />� <br />� <br />� <br />� <br />O <br />� <br />� <br />0 <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the City of Everett from any and all claims for damages, wsts, <br />ezpenses, or causes of action that may arise because of installation <br />and meinT e o i vement or other right-of-way use hereto <br />ap¢lied for and rther ree to remove same upon no ice from the <br />C�y and jo re p li pr erty damaged tliereby. � i <br />WORK AUTHORIZED BY THIS PERMIT MUS� BE�STARTED WITHIN <br />180 DAYS OF DATE PERM�T IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY S70PPAGE OF WOq}C ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />