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., <br /> � <br /> . <br /> . ; f. <br /> x: *W <br /> Date L1-1z-91 �- �j y7/ <br /> � I� � Puplit Worb Pnrmit• <br /> � 91/ 06 — <br /> �� � Application For� BI�O,Dept.s ' <br /> '" � PUBUC WORKS P�RMIT PuoTotalFeeFee s <br /> , ; <br /> ` less�oa�Fee PeiO S <br /> f.l <br /> '+�' �� Pflflt Of T e Onl n � �� �'� "� Baiance Due S 20�� � <br /> ; YP Y oinn �nc. <br /> `, � °: vi .r o :� n� -- <br /> n �.� w [•� .�� r. <br /> �, 1 � M <br /> �n ui <br /> ' ' Bob Schuchard 2529 Ma�le St Everett 98201 258-3156 <br /> " � Owne� MailingA6dPes ' �- '�� Phone • <br /> � �� P t�'.i r� _.. �� „ CitS' Zi� : <br /> �l-� � G' � O t4 �t �� W �c7'y <br /> �> > ❑- _� �- Dennis '.�_ <br /> Permabilt 16521 Hwy-�9 -• �Lpnmvbbd WA 98037 743 1555 Markey ;�y <br /> � Applicant Mailmg Address Cily Lp Phone � � <br /> , ; 'r <br />�^' I Describe Proposed Work P�l a awraaa � � . <br /> i <br />; � <br /> � <br />; ; W I <br /> ' �� Project Address(il known) 2529 Ma le St � <br />�-�S' � Attach four(4)copies of plans for proposed work- Draw to scale and note the following as applicable: � <br /> � • Property Lines � <br /> - • Centerline of street � - <br /> p � Outline and dimensions of all existing and • Indicale Nohh <br /> � proposed structures on t1e lot • Show any proposed grading changes <br /> € • Existirg and proposed utilities • Show measurements �� <br /> � DO NOT WRITE BELOW THIS LINE � ,. <br /> ��� PERMITCONDITIO'VS O ; <br /> 1.All cells for inspection shall be made 24 hrs.in advance•phone 259-881 O. ' <br /> 2.All work shall be pertormed in accordance with this permit and current City oi Everett Design and Construction � <br /> r Standards and Specifications. <br /> 3.Call Lxatlon Underground Service 4B hrs.before you dig.TOLL FREE NUMBER 1-8U0-424•5555. � <br /> k Z 'I <br /> � Q <br /> � �<< � <br /> � � <br /> `: � <br /> � �. <br /> <. <br /> � <br />- i�� . � . ACKNOWLEDGEMENT OF CONDITiONS <br /> �y. ' � The undersigned�wn�r/applicant hereby agrees to hold and save harm� <br /> � less the Ciry ol EvereU Irom any and all claims lor damages, costs, <br /> �� n�i expenses, or causes of action that may arise because of installation <br /> � �j /2�� p/ and maintenance of the improvement or other righFoFway use hereto <br /> � applied lor anu fur�her agrees to remove same upor notice irom the <br /> .i Approved for onst tton � Date City and to reFlace pvblic property damaged thereby� <br /> � ���--/= �3-i� -s � /���(,.c.L,�? �'� �ooJz � <br /> FINAL INSPECTION Date r3�1_,OC'+�rLf�� <br /> � Approved as Constructed SignaWre of Applicant Date <br /> PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST 8E STARTED WITHIN <br /> 3200CederSireet 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTEF IS TO <br /> Everett,WA 98201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone:259-8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DUflATION. � <br />