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� AP�liwtian For <br /> PUBLIC WORKS PERMIT oa�e 11-20-96 _��_/ <br /> PU�LIC WORKS DcPARTMENT Public Works Permic k _���_��_ <br /> 3200 Cedar Street <br /> Everett,WA 98201 259-8810 <br /> , �' `���TING SEP 2 3 �gg7 BuildingPermita 53554 <br /> TYPE OR PRINT ONLY Public Works Fee S (f' _ <br /> Bolin Const PO Box 21 Mukilteo WA 98275 353-7076 <br /> Owner Mailing Address City Zip Phone <br /> Owner <br /> Applicant Mailing Address City 2ip Phone � <br /> Describe Pwposed Work new house <br /> �u <br /> — E- <br /> � <br /> PROJECT ADDRESS(if known) _���� 16ti•� Lot 11 Ridgemont Addr. � <br /> 4tlach four(4)copies of plans for proposed work-Draw to scale and note ihe following if applicable: �A <br /> •Property Llnes 'Outline and dimenslons of all ezisting and proposed struc�ures on ihe lot •Ezisting and proposed utilities 'f ' <br /> 'Centerline of sireet •Indicate North •Show any proposed grading chc^yes •Show measurenients ��� <br /> DO NOT WRITE BELOW THIS LINE '� <br /> PERMIT CONDITIONS: �� <br /> 1.All calls for inspection shall be mode 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 /> �I • � �( l��rtrt d3 �bl�►�G� 3 3� - �63 �r��,� d�o �� s-�-wh � <br /> �,�P S.e��r � cvN�-���fi-�ti �v���s. � <br /> a <br /> �;. _..." "_','��!' _,n,.,.y,.: . r .. <br /> RCI�QS.:.�iSK <br /> SLDG S^06, : <br /> '_^G 56� -:i <br /> wc;:� 35n ''^ <br /> SG�C!'i'G s. -� <br /> -�"�'- aa ��.v .�c.�c <br /> _ p i r- st.�-= -, <br /> ACKNOWLEDG�MENT OFCONDI'IIONS <br /> The undersigned owner/applicatf�Q��y-'Agrees to hold and save harmless � <br /> _ -� the City of Everett from any and�aGtf9ims fot,dat3��9s,cosis,expenses,or <br /> ved fo o a ction y�e causes of action that may aris«�b�aev�'nstallation and maintenance of <br /> ,�" � lheimprovementorotherrighF��y�usehere4�pplia�{orantl(urtheragreas <br /> to remove same upon notice lhe City an�1'�tb``�eplace publi: property <br /> .i; '� j���� �'��-5 � damaged thero,by. ',`:'S^E'.' 3.:;:'i(...C�� <br /> FINAL INSPEi.T10 Date --- ..."r:�' ''�•-..,�� <br /> Approved as C�nst�ucled � <br /> _ ��� <br /> Signature o�' / nt Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 780 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS TO BE DILIGENTLV PI1R:iUED TO <br /> COMPlETION.THIS PERMIT MAY dE CAMCELLED BY THE CIN UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />