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Date 4--7-94 <br />�; <br />Applicalion�or <br />PUBLIC WORI�� <br />¢ <br />Op <br />O <br />Print r�r Type Only � <br />0. <br />� <br />'v <br />John E Thompson 5617 Rockefel] <br />n,.,�.., nn��i�...`,ew.� <br />Owner <br />Describe Proposed Work new <br />Project Address (if knownl <br />TO POSTING �� �G'"��� <br />PERMIT <br />011l O1� <br />O � 3 O M <br />P �CJN <br />tli eM1 � <br />Ave Everett <br />� x <br />� <br />o ,�;� y <br />��U� <br />WA 98203 <br />Zip <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the following as applicable: <br />• Property Lines <br />• Outline and dimensions of all existing and <br />proposed structures on the lot <br />• Exis�ing and proposetl utili�ies <br />Publ¢ Works Permil • / �_ / <br />eiao� oeo�. • 4404 S __ <br />Publie Wo�ka Fee <br />To�ei Fee s <br />Less AOPL Fee PeiC S <br />UO <br />Belance Due S —�� ` <br />D��2-312 yo/is, / <br />• Centerline of street <br />� Indicate Nnrth <br />• Show any proposed grading changes <br />• Show measurement; <br />rnone <br />Phone <br />PERMIT CONDITIONS <br />t. All cells tor inspection shell be made 2a hrs. in a�lvance • phone 259•8810. <br />2. All work shall be pertormed in accordance with tliis permit and current City of Everett Design and Construction <br />Standards and Specificetions. <br />3. Call Location Underground Service 4B hrs. befon+you dig. TOLL FREE NUMBER 1•800-424•5555. <br />y /ad �LLe f/ �e�ro oi!,.Y <br />4/rf /n /�7c: 4((eV. <br />/ <br />a�Ca�vec✓ Or �p��'cE.•nei� 7c 07r <br />r��� y o 9� <br />Approved for Construclion Date <br />.�/ .�� �f'= � 7- -Z s' gY <br />FINAL INSPECTION ate <br />Approved as Constructed <br />/�r�PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett WA 98201 <br />Phone:259•8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />H <br />� <br />� <br />O <br />� <br />� <br />O <br />a <br />The undersigned owner/applicant hereby a9rees to hold and save harm� <br />less the Cily of Everett trom any and all claims for damages, costs, <br />expr.nses, or causes of action that may arise because of installation <br />and maintenance of ihe improvement or other right-of�way use hereto <br />applied for and turther agrees to remove same upon notice irom the <br />City and to replace public prop=rly damaged thereby. <br />� � ��� ya��y <br />i nature ol Applicanl D e <br />W RK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER �S TO <br />8E DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVEH 90 DAYS DURATION. <br />