17 E MARILYN AVE 2016-01-01 MF Import

, Date 7-9-93 Z l '' ��TING��`� Applicallon For � g �� ' � P'''�'c worke Permit• � � PUBLIC WORKS PERMIT B1aa oeo,.� 412 W blic Worhe Fee Totel Fee S I Pflflt Of T)/pg ��Y lesaApOi FeePaie S-_ � Bslance Due S Donald Lacha elle 10131 lst Dr SE � Owner Mailing qddress — City Zip OWneL . Phone Applicant Mailing Add�es�. City Zip Describe proposed Work �ne�house Phone Project Address(il known) _l ( �, ,�^ ■ � ■ "I?.y^� W Attach four(q)copies of plans for proposed work• Draw to scale and note the fo�lowin � . • Property Lines g as applicable: • Outline antl dimensions of all existing antl � Centerline of street � proposed structures on ihe lot � Indicate North � • Existing and proposed uNlities • Show an� ro ) P posed grading changes � 8how measuremerts DO NOT WRI7E BELOW THIS LIN[ � PERMIT CONDITIONS 2.All Wpry�8hall bepelAormed n accordancerwith tldiis permitand cu2r e9t�yo Everett Design antl Constructton O Sfendards and Specificallons. � 3.Call Location Underground Service 48 hrs,before you dig.TOLL FREE NUMBER 1•$ �0-424•5555. � O � � O a C yj ACKNOWLEDGEMENT OF CONDITIONS The andersigned owne�/applicanf hereby agrees to hold ana save hann- less the City ol Everett Irom any and all claims for damages, costs, � � expenses. or causes of action that may arise because of installation Appro e and maintenance of the improvement or other right•of•way use hereto onstruct'on, applied lor and further agrees to remove same upon notice from the Date ��y;�nd to replace public ro �,�" / P perty damayed thareby. � � -'L L SP � .`--" � Approved as Constructed � Date (,{.�,, � natur�of qpplicant �� PUBLIC WORKS DEPqqTMENT WORK AUTHOqIZED BY THIC PERMiT MUST BE STARTED WITHIN 3200CedarStreet 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO Everett,Wq ggZp� BE DILIGENT�Y PURSUED TO COMPLETION. 7HIS PERMIT MAY BE Phone:259-B810 CANCELLED BY THE CITY UPON ANY STOPPqGE OF WORK ON 7HIS PqOJECT OVER 90 DAYS DURATION.