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Date 6/�/69 <br />Appli�a'ion For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Pu�t'rt Wods Parmi� � <br />amo.oao�.• 94/139b�7 <br />Pu01�c Works Fee <br />Total Fee S - <br />Less ApPL Fee PeIE s <br />BelenceDue S ��•�� <br />Everett Cheimber of Com;r.erce 171G t�iest Etarine Vie•d Lri•✓e <br />96201 252-5106 <br />Owner Mailing Address City Zip Phone <br />CoUra Construction Co. P.O. Br:. 1299 I-:verett <br />Applicanl <br />Describe Proposed Work <br />Mailin.r, Address <br />Building `telocntion <br />Zip <br />�8200 258-36u7 <br />Project Address (il known) 1710 i7est Marine View Drive <br />Attach four (4) copies of plans lor proposed work • Draw to scale and note the lollowing as applicable: <br />� Property Lines • Centerli�e of streel <br />• Outline and dimensions ol all existing and • Indicate North <br />proposed structures on the lot • Show any propr,sed grading ch��nges <br />• Ezisting and proposed utilities • Show measureinents <br />j PERMIT CONDITIONS <br />I 1. All calls for inspection shall be made 24 hrs. in ad��ance - phone 259-881 5. <br />2. All work shall be perfo; med in accordance with tnis permit and current City of Everett Design and Construction <br />IStandards and Specifications. <br />, 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMFIeP, 1-300•424-5555. <br />A <br />���Y 7.� /(� <br />,��(�" ` !/ <br />Consiruction <br />�j �7 v ��GC�C: � , / <br />Date <br />FINAL INSPECTION Date <br />Approved as Conciructed <br />everett PUBLIC WORKS DEPARTMENT <br />� 3200 Cedar Street <br />Everelt. WA 98207 <br />Phone: 259-8815 <br />� <br />� <br />'�w , <br />_ / <br />O <br />a <br />ACKNOWLEDGEM1IENT OF CONDITIONS <br />The undersigned o�vner/applicant hereby agrees to hold and save harm� <br />less ihe City ol Everett Irom any and all r.laims for damages, costs, � <br />expenses, or causes ol adion ihat may arise because ol installation . <br />and maintenance of the improvemenl or other rigM-ol-way use hereto <br />applied for and Iwiher agrees to remove same upon notice Irom Ihe � <br />City and to replace public property damaged ihereby. <br />�y�'_ ��i��-.-� l''����2'y � <br />Signature ol Applicanl �Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN � <br />180 DAYS OF DATE PEFMIT IS ISSUED AND THEREAFTER IS TO �� <br />BE DILIGENTLY PUFSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON TfiIS <br />PROJECT OVER 50 DAYS DURATION. . <br />z <br />O <br />--I <br />c"f <br />m <br />.. .. <br />--i -n <br />..� <br />N 2 <br />m <br />0 <br />c o <br />m o <br />-a c <br />O 3 <br />m <br />_ -�-i <br />m <br />�. <br />.o � <br />n -� <br />rx <br />.� .. <br />-i N <br />< <br />� <br />o z <br />Ta <br />-� m <br />s <br />m N <br />0 <br />o r <br />C N <br />� <br />m' <br />� � <br />• m <br />a <br />A <br />--1 <br />2 <br />n <br />z <br />ti <br />ti <br />� <br />Z <br />0 <br />.� <br />� <br />� <br />m <br />