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� Appli�'on Fo�� P 0 ST I N G Auc n 4 �ss� f�� <br /> , <br /> ��� PUBLIC WO�iKS PERMIT oate 4/10/96 <br /> �se��r � ¢ <br /> /' PUBLIC WORI�DEPARTMENT Public Works Permit k <br /> 3200 C�r Street <br /> Everett W.'.9 1 259-8810 BuilJing Permit u 51'i9R <br /> g �!' g o 0 <br /> TYPE OR PRINT ONLY o M � � Publ!c vJorks Fee$ �� ' __ <br /> Bfi <br /> RYNER HOMES INC 10909 DUBUQQ$ R1� SNOH041ISH 9£290 360-8839 <br /> Owner Mailing Address M � � ' $ � � City Zip Phone <br /> S <br /> � � � 2� � <br /> Applicant Mailing Address City Zip Phone <br /> Describe Proposed Work "W DUPLEX - BASIC 1183 � <br /> �� �� � _� � <br /> ♦�A <br /> — V♦ <br /> PROJCCT ADDRESS(if known) ?32 7 A � 8'���/Pl^D/^, $LDG 2 <br /> Attach four(4�copies of plans tor proposed work-Draw to scale and note the following if applicable: � <br /> 'PropfMy Linas `Outline and dimensions of sll exlsting and proposed siructures on ihe lot •Existing and proposed utilities O <br /> 'Centedine ot street •Indicate North •Show any proposed grading changes •Show measuremenis � <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 Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � <br /> 9, GUo�.E � !� do/-�c �Br G..�rolieo' �(,Q s� O <br /> d�.�c��Z/9� ��� �4�d� a <br /> ACKNOWLEDGE�dENT OF CONDITIONS <br /> The undersigned cwner/applicant hereby agrees to hold and save harmless <br /> t -L t� � 6 ine City of Everetl from any and all claims for damages,costs,expenses,or <br /> causes ol action that may anse because of installation and maintenance of <br /> Approv r onstruction �e theimorovem=ntorotherright-of-wayuseheretoappiiedforandfuriheragrees <br /> > to remove �me upon notice 6om the City and to replace public propeAy <br /> q f damaged�hereby. <br /> FINAL IN E 10 Da e <br /> Approved as Constructed �^��, <br /> .ti.J S•i3-9C <br /> Signature of Applicant Date <br /> WORK AUTHORIZED BY TH�S PERMIT MUST BE STARTED WI7HIN 780 DAYS Of DATE PERMIT IS ISSUED AND THEREAFfER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLETION.THIS PERMIT MAY BE CANCELLED BY THE CI7Y UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />