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Date 9-25-95 �s �8� <br /> Puphc Worka Permll• <br /> Appiication For eieo oea�.-- 49574 <br /> PUBLIC WORKS PERMIT P�DI¢WarNaFee <br /> To�r�F« s___ <br /> Less�p0�Fee Paip S <br /> Print or Type Only BalanceDue a .�D_�— <br /> �— <br /> Coffell Don/Nancy 1 22 Rockefeller Ave Everett 98201 252-/i098 <br /> � Owner Mailing Atldress �;�Y <br /> Z�p Phone <br /> North Sound Builders ,Tohn 653-2512 <br /> Applican� Maitinp qddress <br /> City Zip Phone <br /> Describe Proposed W'ork detaChed garaRe <br /> Pro)ect„d �� 1822 Rockefeller Ave � <br /> Attach four(4)conies of�lans lor proposetl work• Draw;o scale antl note Ihe lollowing as applicable: � <br /> • Properry Lines • Centerline ol st.eel �� <br /> • O�tline and dimensions of all existing and • Indicale North � <br /> proposed slructures on the lot • Show an <br /> • Existing and proposed utilities y Froposed gratling changes <br /> • Show measurements <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS O <br /> 7.All calls for inspection shall be made 24 hrs.in advance•phone 259-8810. <br /> 2.All work shali be performed in accordance with this permit and currcnt City of Everett De,ign and Construct(on � <br /> Standards and Speclticatlons. <br /> . 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1•800•424-5585. <br /> �. /�vist S/d�—Sai�er {yl�2ri�L Uh0¢r /1ew p2 �. i� <br /> �_ i^w t O <br /> T CohFo.-m �fp Unrfo�n P�u.,�di� Ce�/e. <br /> � <br /> � <br /> O <br /> �� , <br /> a <br /> ACKNOWLEDGEMEN7 OF CONDITIONS <br /> The undersigned owner/appiicant hPreby agrees to hold and save harm- <br /> � � less the City of Everett Irom any and ail ctaims for damages. r,�sts. <br /> ez enses. or causes of action that may :.�ris� 6ecause of installation <br /> 9/ps— and maintenance of Ihe improvement or other righl-of-way use hereto <br /> Aporoved fo onstruction �a j Dale app�'ed lor and further agrees to renove same upon no�ice trom Ihe <br /> � City and to replace public property damaged thereby. <br /> I <br /> FINAL INSPEC710N <br /> Approved as Constructed Date <br /> Signalure of Applicant Date <br /> PUDLIC WORKS DEPARTMENT wORK AUTHORIZED BY THIS PERM17 MUS7 BE STARTED WITHIN <br /> 3200CedarStreet � t80 DAYS OF DATE PERMIT IS �SSU[D AND THEREAFTER IS �TO <br /> � Everelt,WA 98201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone:25g�6810 CANCELLED 8Y THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> � PRO.IECT OVER 90 DAYS DURATION. <br />