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s1�c� �� ��SIING AUG 0 9 1997 <br /> ApMlication For / <br /> � PUBUC WQRKS PERMIT Date 4/10/96 <br /> PUBLIC W mKS DEFARTMENT Public Works Permit k � �� <br /> 320 edai Sireet <br /> EveretL WAg'L01 259-8810 Building Permit p�13.9J_ <br /> r � g � p0 <br /> TYPE OR PRINT ONLY o 0 0 0� Public Works Fee$ 2�� <br /> M <br /> «; a «. 68 <br /> RYNER HODfES INC 2Q909 DUBIIQUE �D SNOH� I;�Fl ' �:�90 360-8839 <br /> Owner Mailing Addres�� �ppa. � �po. .r^-s � Ciq� Zip Phone <br /> M � � �r,J -�+ W <br /> � � � � � <br /> Applicant Mailing Address� City 2ip Phone <br /> Describe Proposed Work NEW BUPLEX - BASIC 1183 � <br /> — �'` ' . � <br /> � <br /> PROJEC7ADDRESS(ifknown) �.��5�9��• �4iniPrl����/ � <br /> Aqach four(4)copies of plans for proposed work-Draw to scale antl note the following if applicable: � <br /> •Property Lines "Outlina and dimensions of all existing and proposed structures on the lot •Existing and proposed utilities O <br /> 'Centedine of street •Indicate Norh 5how any proposed grading changes •Show measurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS: Z <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 Speciiications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424•5555. � <br /> �. Cv/'G o�i^iCl s�cuar f»�t in Per Ci� Sf'Qn�.,p� � <br /> f�lo/2 4•,d '�rv/3 O <br /> J�. .L�sfcl� CG+4'/� �its�n �D�r Sf�no� '��03 �' 4�� 4f � <br /> N.Cv Corv�tr oF Drivt'a�a.}/ 4no� DQY lf/�f �p <br /> o�rQ...ayt cho.,�eL 4s d/�c7`��� f/�c �odCiG <br /> Lc>o�^i�' /nsPaC�or. <br /> (p, �(JOr,� t0 �J' c don[ �p�.r �a[lcd PLan, / �4�/ `7 2�/� <br /> l <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> � A J // The undersigned owner/applicant hereby aqrees to hold and save harmless <br /> ��{ � q �9 9G the City of Everett from any and all claims for damages,costs,expenses,or <br /> ���d`a�`y causes ol action that may arise because of installation and maintenance of <br /> Approve IorConsiruction ale theimprovementorothernght-of-wayusehereroappliedforandfurtheragrees <br /> � ^ to remove same upon nntice irom ihe City and to replace public property <br /> �� � / �_3�¢ �? damaged Ihere y. <br /> A ECTION 'T � Dat � ( ���� <br /> Approved as Constructed <br /> •,-`.J .S'is-R ja <br /> Signature of Applicant Date <br /> \YORIC AUTHOHIZED 8Y THIS PERMIT MUST BE STAFTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS TO BE DILIGENttY PURSUED TO <br /> COMPi_E710N.THIS PERMIT MAY BE CANCELLED BV THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />