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Date <br />Application for <br />PUBLIC WORKS PERIVlIT <br />Print or Type Only ApplicatCDate: 08/11/93 SEPA <br />Job Address: 2010 MUKILTEO BLVD <br />Owner: e1NUERSON BOB & DORITA <br />Tenant: <br />Proposed Use: SINGLE FAMILY RESIDENCE <br />Desc. of Work: <br />Owner LIVING ROOM ADDN <br />_ OFFICE SET JOB SET <br />Applicant <br />Describe Proposed Work <br />Project Address (if known) <br />APPROVED FOR PERMIT: DATE_/_�_ gy <br />i nuniic lvorxs Pcrm;� . _ <br />BIOp. De01. r <br />PuElic Work! Fee <br />Total Feb S _ <br />LeSaApPlFee?eIE $_ <br />Ba�ance Oue S _ <br />Z�P Phone <br />Z�P Phone <br />Attach four (4) copies cf plans lor proposed work • Draw to scale and note the following as applicable: <br />• Property Lir.es • Centerline ot sireet <br />• Outline and tiimensions of all existing and • Intlicale Nor�h <br />proposed stnictures on the lot • Show any proposed grading changes <br />• Existing and aroposed utilities • Show measurements <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hrs. in advance- phone 259•8810. <br />2. All work shall be pertormed in accordance with this permit and current City of Everett Desiqn and Construction <br />Standaids and Specifications. <br />3. Call Localion Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800•424•5555. <br />�'l;5UG WORKS P[RMIT <br />NOT REOUIRED <br />i <br />(?Y_ `7%� <br />i. <br />�ll, i F �S .// .� i <br />Approved lor Construction Date <br />FINAL INSPECTIOh <br />Approved as Cunslructed <br />/� PUBLIC WORKS DEPARTMENT <br />� 3200CedarStreet <br />Everett, WA 99207 <br />Phonr.: 259�BB10 <br />Date <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />� <br />! <br />� <br />� <br />O <br />� <br />� <br />0 <br />� <br />� <br />O <br />a <br />Thc undersigned owner/applicant hereby agrees lo hold and save harm- <br />less the City ol Everett irom any and all claims for damages, costs, <br />expenses, or causes of action that may arise becausa of ir.stallation <br />and maintenance ol the improvement or other rinhFof•way use hereto <br />applied for and further agrees to remove same upon notice from ihe <br />City and to replace public pro�erty damaged thereby. <br />Signalure of Applicant Date <br />WORK. AUTHORIZED BY THIS PERMIT MUST 8E STARfED WITHIN <br />180 DAYS OF DATE PERMIT IS iSSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />