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I <br /> .� MPlication For <br /> PUBLIC WORKS PERM►T °e�e 1-1s-9' <br /> f'UBLIC WORKS DEPARTMENI' Public Woiks Pertnit N _�Q.3� <br /> 3200 Cedar Street <br /> Everetl,WA 98201 259-8810 Building Pen,dt M 53948 <br /> TYPE OR PRINT ONLY Public Works Fee$ 7B�'-�L _ <br /> Larry Kjolso 7096 44th P1 W Mukilteo 98275 745-6063 <br /> Owner Melling Address City Zip Phone <br /> owner <br /> Applicant Mailing Address City Zip Phone <br /> Describe Pruposed Work temp tent structure for retail fruit & produce stand � <br /> � <br /> � <br /> PROJECT ADDRESS(if known) z� — E, /�q/v�c U �cc/ r � <br /> Attach tour(4)copies of plans for proposed work-Draw to^,cala and note the following if applicable: O <br /> •Property Lines 'Outline and dimensions of all ezlsting and proposed structures on the lot •Existing and proposed utilitles <br /> •Centerline of street •Indicate North •Show any proposed grading changes •Show measurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS: � <br /> 1.All calls for inspection shall be made 24 hours in advance- phone 259-8810. O <br /> 2. All work shall be performed in accordance with this permit and current City of Everett Design and <br /> Construction Standards and Specifications. <br /> 3. Cali Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � <br /> � (NIJl��C Z�O 6e: �/,�t �,�r C.j��f-o°�d O <br /> Sr{�: ,o�Qr, — Co� Q�Qcl�.Q! <br /> .� s�� ���,�,,,;� �%P� 4�0,��d� s� = �- = „-�: � a <br /> '�2-J�" �D�Q6in/h� C�O�?��?�riS. �h ';:L;09'':�;., , <br /> / J { <br /> 1��:�h�.f% L:Ve <br /> �. Q7y' ��riir �;�,4/,��,f f+�./�:cf' cuill /'��u..,e �:���:s i,,7.��, <br /> /ri• �•evc��e��/S� 6e done 7� 5�,� :tc:�i_6."^, <br /> �' I /tr LSD. :dAT�� � ��--`�' <br /> t„-,�; . 'c - <br /> __ ��. <br /> r/'"i��y <br /> ' - ACKNOWLEDGEMENTOFCGNDITIONS <br /> / The undersigned owner/applicant heieby agrees to hold and save hartnless <br /> , a y� p the City of Everetl from any and all cleims for damages,costs,expenses,or <br /> A proved Constry o Date causes of actlon that may arise because ot installetion and maintenance of <br /> L the improvement or other ri�ht-of•way use hereto applied tor and fuAher agrees <br /> to remove same upon notice f�m the CRy and to replace public property <br /> �-/1 •>!� damagedt by. <br /> FI I ECTI - Date // <br /> Approved a: :onstructed � , � <br /> atureof IicanC Da:e <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT�S ISSUED AND THEREAF7ER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLETION.THIS PERMIT M1tAV BE CANCELLED BY THE CIN UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />