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a <br />y5c� � <br />t�f�y <br />m�x <br />a Hx [n <br />H z� <br />� H� <br />h�C H'� <br />fA H�+ <br />ts7 O [�f <br />�3 <br />OH <br />�/1�g <br />y� V �C <br />rHz <br />Hy <br />g �' <br />��� <br />C <br />x y c�n <br />H O [n <br />�— — <br />_� <br />��� <br />� ' � <br />�/-3S-z9-4 <br />Date 3/3/92 <br />. Applicalion For <br />PUBLIC WORKS PERMIT <br />TO POSTING �/�.� <br />Print or Type Only <br />/ <br />mmi��wo�k,a��mn358 U -- <br />oieq oeo� • <br />Puol2 wods Fea 5 <br />To101Fne <br />LesaPool fon PaN 5 � <br />O:Jan.c fJdr $ '�� <br />NSC POB 3376 Cverett 98203 348-8308 <br />Owner , � Mai�InpAddress � City Zip Phone <br />Mailin9 Address City Zip Phone <br />Applicanl <br />Descrihe Proposed Work New 1262sf SFR / 374sf Gar — <br />Prolect Addre55 (il known) Z 33 ����• M U K I �.TEO VL� <br />Altach lour (4) coUies ol plans for pwposed work • Draw to scale and note Ihe following as applicable: <br />• Property Lines • Centedine ol sireet <br />• Outline and dimensions of all exisling and • Indicate North <br />proposed structures on ihe lol • Show any proposed grading chan9e5 <br />• Ezisting and proposed utilities • Show measurements <br />PERMIT CONDITIONS <br />1. All calls lor inspection shall be made 24 hrs. in advance - phone 259•8810. <br />2, All work shall be pedormed in accordance with ihis permil and current Cily of Everett Design and Construction <br />Standards and SpecilicaUons. <br />3. Call Localion Underground Service 48 hrs. be�ore you dig. TOLL FREE NUMBCR 1•800•424-5555. <br />Q, Cv�/lec-'f Oow� SPo��S <br />Sr f aV�. Gi (� i V-f_w c�7 —t'YOM <br />-fa edq� o-F �ducr-c�.�� <br />�� <br />lor Gon<_�Ir/uction <br />, Y // <br />Approved a5 GOn,lrucletl <br />�PUBLIC WORKS DEPARTMENT <br />�3200CedarStreet <br />Everett, WA 98201 <br />Phona: 259•8810 <br />J <br />— I� - 9�,,, <br />Date <br />G ✓G-i<- <br />Date <br />�o -�rter��� I�v�,l-� s . <br />-�run� f�R'4��'�`� I ��C <br />,��,, � o.c.�. <br />W <br />� <br />� <br />� <br />Z <br />O <br />� <br />� <br />0 <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersi9ned owner/applicant hereby a9rees to hold and save harm� <br />less the Ciry ol Everelt irom any and all claims tor damaqes, costs. <br />expenses, or causes ol action that may ar because ot installation <br />and maintenance of Ihe linprovement or other �i9hFof•way use hereto <br />applied lor and luriher ag�ees to remove same upon notice irom the <br />City and to replace public property damaged Ihereby. <br />%��Lti.� �_t��'t-� . Y�13�% L <br />Signa�ure ol Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT UST 8E STARTED WITHIN <br />100 D�YS OF DATE PERMIf IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BV THE CITY UPON ANY SiOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAVS DURATION. <br />