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Date 4/ 9 Public Works Permit# _ <br /> Application For Bldg.Dept # 91/2673. <br /> PUBLIC WORKS PERMIT PubTotaFeeFee - <br /> - <br /> Less Appl.Fee Paid $ --, ... <br /> Print or Type Only Balance Due $ 4 <br /> Danlap Towing Co. PO 8crx 593 raOaraler, WA 98257 466-3114 <br /> 'Owner Mailing Address City Zip Phone <br /> Owner <br /> Applicant Mailing Address City Zip Phone <br /> Describe Proposed Work Construct new wood chip handling facility • <br /> W <br /> Project Address(if known) 616 Rasa Ave. inn <br /> Attach four(4) copies of plans for proposed work Draw to scale and note the-kollowing as applicable: i <br /> • Property Lines , Centerline of street ,Cn <br /> • Outline and dimensions of all existing and • Indicate North <br /> proposed structures on the lot • Si ow any proposed grading changes <br /> • Existing and proposed utilities • ahow measurements <br /> DO NOT WRITE BELOW THIS LINE �Y <br /> PERMIT CONDITIONS -. 0 <br /> 1.All calls for inspection shall be made 24 hrs.in advance-phone 259-8810. n <br /> 2.All work shall be performed in accordance with this permit and current City of Everett Design and Construction <br /> Standards and Specifications. <br /> 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1-800-424-5555. z <br /> jam' ""tor - 4 4-. ..$ - , <br /> 0 <br /> w .4. 0. <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm- <br /> less the City of Everett from any and all claims for damages, costs, <br /> . . ,.r - ) expenses, or causes of action that may arise because of installation <br /> f ems` 7.W and maintenance of the improvement or other right-of-way use" hereto <br /> applied for and further agrees to remove same upon notice from the <br /> Ap/-* <br /> ed f6 C str N ,ion ; Date <br /> �/f� // / <br /> City and to replace public property damaged thereby. <br /> FINAL INSPECTION Date �f :d ', , i /P� <br /> Approved as Constructed - S4g atur f A cant Gate <br /> V)Q K A HORIZED BY TT PERMIT MUST BE STARTED WITHIN <br /> everett PUBLIC WORKS DEPARTMENT 18u DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> e3200 Cedar Street BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Everett,WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259-8810 PROJECT OVER'90.DAYS DURATION. <br />