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:;'f, �OSTING No�q� <br /> Application For � <br /> � PUBUC "NORKS PERMIT Date 11-20-96 _ <br /> ����, �— <br /> PUBLIC WORKS DEPARTMENT public Works Permit# <br /> 3200 Cedar Sireet <br /> Everett,WA 98201 259-8810 .. ... <br /> Building Pennit p •—T.rivu- �.3� <br /> TYPE OR PRINT ONLY Public Works Fee S.�__ <br /> Bolin Const PO Box 21 Mukilteo WA 98275 353-7076 <br /> Owner Mailing Address City Zip Phone <br /> Owner <br /> Applicant Mailing Address Ciry Zip Phone <br /> Describe Proposed Work new house � <br /> � <br /> � <br /> PROJECT AUDRESS�if known) �1 rn4W"f Lot 12 kid emont Addn � <br /> A9ach four(4)copies of plans for proposed work-Draw to scale and note the following if applicable: � <br /> •PropeAy Lines 'Outline and dimensions of all existing and proposed structures on the lot •Existing and proposed utilities O <br /> •Centerline of street •Indicate NoAh •Show any proposed gr2ding changes •Show measur=ments � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS: � <br /> 1. All calis for inspectior shall b< 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£�ecifications. <br /> 3. Cali Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � <br /> � (�° UI �Gv�a'n G►�-(ov"c�•+ G� 339 —7¢0 , o.i,^ii7��:.>a�w���i' � <br /> . , Gvi . 3 �fJ✓loY; ' <br /> � �.^o��,��� 0 <br /> �'�{� S-e"W � Cv''�.5�1'L�c�,�✓1 �p✓��rt��-''��?69,�� <br /> l� `�� ssa.00 a <br /> rSrcN =•:o.o0 <br /> SRCHFG s4SJ <br /> DFIVWI' g�O.JC <br /> °LW CH 3?4..� <br /> ik00N)9242 <br /> ;dAT_R 4�650.7� <br /> anJ0:9953 <br /> ;;EWE+. 370.00 <br /> SVSDEV °,?�PS.UI <br /> C EC; S30 ^r <br /> � t ce ` <br /> •;9� <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> ,� � J� 1�e undersigned ownedapplicant hereby ayrees to hold and save harmless <br /> ��� lhe City of Evered Irom any and all claims for damages,costs,expanses,o� <br /> ` ' causes of action that may arise because of Installatlon and maintenance of <br /> A ovc f C� ruction Dat theimprovementorotherrigM-of-wayosehe2loappliedforandfurtheragrees <br /> t o r e m o v e s a m e u p o n n o t i c e f ro m the Cit y and to re place public pro peA y <br /> �f+�� _ damaged thereby. <br /> �-�-5 7 <br /> FINAL INSPECTION Date <br /> 4pproved as Conslnicted / � _/' <br /> % <br /> ign ure o plicant Uate <br /> WORK AUTHORIZED BY THIS PERMIT MUST B[STARTED WITHIN 180 DAYS OF D IT IS ISSUED AND THEREAFfER IS TO BE DILIGENRY PURSUED TO <br /> COMPLEfION.THIS PERMIT MAY BE CANCELLED BY THE CIN UFON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />