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TYPE OR PRINT ONLY <br />Application For <br />PUBLIC WORKS PERMIT Date <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 259-881 2 13 2000 <br />TO POSTING FEB <br />3-26-98 <br />Public Works Permit If <br />Building Permit M 58308 <br />Public Works Fee E 713 <br />Snoh City Public Works 2930 Wetmore Ave Everett 98201 388-6491 Jim Wilson <br />Owner Mailing Address City Zip Phone <br />Owner — <br />Applicant Mailing Address city Zip Phone <br />Describe Proposed Work curb, gutter, sidewalks <br />PROJECT ADDRESS (if known) -3*9-2cDougall Ave lNl•�-lJ. av<<dii <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the following if applicable: <br />OProperty Lines 00utline and dimensions of all existing and proposed structures on the lot •Existing and proposed utilities <br />`Centerline of street •Indicate North 'Show any proposed grading changes 'Show measurements <br />PERMIT CONDITIONS: <br />1. All calls for inspection shall be made 24 hours in advance - phone 259-8810. <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. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 14X*-424-5555. <br />�. <br />Clv`L iuor/ <br />teo �e �ov� Per <br />PL4h <br />ahPrave J fy <br />Pv6L, c LcJC1rFJ <br />oh 5`2 7- id <br />S-2 7-. 9 e <br />Appr a to a r4ctio Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />�IQa l D <br />IUI JUN C _ 1.98 <br />C1.-ry GtF <br />Permit <br />co <br />0 <br />M) <br />z <br />0 <br />0 <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harmiess <br />the City of Everett from any and all claims for damages, costs, expenses, or <br />causes of action that may arise because of installation and maintenance of <br />the improvement or other right-of-way use hereto applied for and further agrees <br />to remove same upon no!'oe from the Citv and to replace pudic property <br />WORK 4UTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE L RMIT IS ISSUED AND THEREAFTER 14YO BE DILIGENTLY PURSUED TO <br />COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OtIcR 9010AYS DURATION. <br />