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/�Mr��� APPlication For � <br /> � PUBLIC WORKS PERMIT Date 8/5/96 -/ <br /> PUBLIC WORKS DEPARTT�IT Public Works Pertnit# ��/ZRg <br /> 3200 Cedar Street y . <br /> Everett.WA98201 259-�7p � <br /> $ BuildingPermitA_ s9477 <br /> TYPEOR PRINTONLY �� pOSTING� 1 O 1�7� � S $ S3 S Ri <br /> —�—�_ N � � � � � Public Works Fee$ � <br /> ANDERSON DAVID r%a « """ '" « <br /> — 21 E MARILYN AVE EVER T 98208 <br /> Owner <br /> Mailing Address — <br /> 0�`'A�ER 435-0724 N\��^ n�1tn�Yzy � � �S Z�P Phone <br /> �+Apucant � �� 7i' §�+ � � � <br /> y r�aaress O City ' <br /> Z�P Phone <br /> Describe Proposed Work NEW HOUSE <br /> - W <br /> � <br /> ♦-/� <br /> PROJECT ADDRESS(if known) 21 E MARILYN AVE V♦ <br /> Attach four(4)copies of plans fcr proposetl work-Draw to scale and note the following if applicable: � <br /> �P�oPerty Lines 'putline and dimensions of all existin and ro sed structures on the lot <br /> 'Centerline of street •Indicate North •Show a n•nroposetl gradin chan es �Ex�sting and proposed utilities O <br /> 9 9 •Show measurements <br /> Du NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS: <br /> 1.All calls for inspection shall be made 24 hours in advance-phone 259-&810. Z <br /> 2. All work shall be pertormed in accordance with this permit and current City of Everett Design and <br /> Construction Standards and Specifications. O <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-80p.424-5555, <br /> `� !�Sfif�/ �c. -�''�jiG 5,,,,.,r� ,�v,,, hm�re �o �r�p . G;,� � <br /> . w.� G �' � o. � t P,.b�, �,h.�. G.,� � std ��'01 � <br /> a <br /> �� (� 6�7G <br /> ���i///� I//G The undersiyned owner/oappl centEhereby�greesNolholdJ nd save hartnless <br /> " �• Pi��r�•7�p the City of Everen from any and all claims for damages,costs,ex <br /> APPro� r Consiruction Date causes of action ihat may anse because of installatlon and maintenance of <br /> � the impmvement or other right-obway use hereto applied for and further agrees <br /> l } to remove same upon notice from the City and to replace public property <br /> .FI AL I PcCT10 � � damaged thereby. <br /> Approved as Constructed Date <br /> �'M !9 <br /> Signq} ppncan[ Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STAFTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THER <br /> COMPLE710N.THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK�N THIS PROJECT 0 ERRgp DAYS DURATION.Y PURSUED TO <br />