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... <br />F <br />,r, <br />� <br />Date1�-��-o� <br />Applicatl� or <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Puohe woua Pum:t • <br />eieoo.o�• 91/28173 <br />WOlie wonu Fw <br />ioul Fw = <br />L�u ADO'. � N P�iC i <br />Ba4nn Dw f <br />__PORT OF EVERETT PO BOX 538 EVERETT 982�� 9_�764 <br />Owner MaiNng Atldresa City Zip Phone <br />NARBOR MARINE 1402 W MARINE VIEW DR EVERETT 98201 259-3285 <br />Applicant Mailing Address City Zip Phone <br />DeecNbe Propoaed \Nork TI <br />Project Address (If known) <br />Attach !our (4) copiea af plane for proposed wark • Oraw to scale and note the foliowing as appllcable: <br />• Property Linea �• Centerline af street <br />• Outline and dlmenstona ot all extating end • Indicate North <br />propOsed structures on Ihe lot • Show any proposed grading changes <br />• Existinq and proposed utllitles • Show Teasurements <br />PERMIT t:ON01T10NS <br />1.IUI rall� for inspectlon eh�ll be m�ds 24 hre. In edvance • phone 259-8810. <br />2 All work sh�ll bs pertormed in axoN�ncs with this permit end current City oF Evarott Dealqn and Construction <br />SUndud� md 3peelflc�tlons. <br />3. GII Loatlon Undsrpround 5ervics 48 hrs. beforo you dip. TOLL FREE NUMBER 1-800�42455SS. <br />T �/� L<lo'zI�- /9a'�.n'.� i�('�,���a,�� <br />i/�' <br />ll-2� i l <br />Approv�d for Conetruclion - � Date <br />FINA� INSPECTION Data <br />Apprwad as Con�hucted <br />PUBLIC WORKS DEPARTMENT <br />3200 CWv Stroat <br />Ewntt, WA 98201 <br />PI�onM 26&BB70 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />� <br />� <br />� <br />� <br />� <br />The undenipned owner/applicant heroby aqrosa to hold and seve harrr <br />lees the City of Everett from any �nd all claima lor damapea coet: <br />expensa0. or cauaes of actlon that may arise because of inatalletlo� <br />�end malntenance of the Imprwement or other Npht•ot•w�y use heret <br />epplied for end further �prsea to romovs �ame upon notice from th• <br />City �nd to replece publlc property dnmaqed theroby. .. � � <br />SlOneture of Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHI; <br />160 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS �T� <br />BE DILI(iENTLY PURSUED TO COMPIETION. THIS PERMIT MAV 8 <br />CANCELLED BY THE CITY UPON ANY STOPPADE OF WORK ON THi <br />PROJECT OVER 90 DAYS OURATION. <br />, __ �, _ .. . __.. _... .-_.,-.�.--........--;s-,'t .. . / <br />_.,_ J <br />