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!11 <br />4/16(92 <br />Date <br />U � Cq-24�-5 <br />Application For <br />TO POSriNG �0��0�� <br />PUBLIC 1MORKS PERMIT <br />Print or Type Only <br />�_ / <br />Puebc vlorxs Parmn . � � <br />emQ o�oi + 36380 <br />Publ¢ WorEs Fex <br />Total Fee S <br />Less Ppol. Fne Poid $ <br />� �� � <br />Balance Duc <br />0'Connor & Oehler Const Inc 9210 Gver�reen Wy EvereCt 98204 353-7700 <br />Owner Mailing Atldress �� � ;� � City ZiU Phone <br />Mailing Address Ciry Zip Phone <br />Descri6e Proposed Work <br />Project Address (it known� <br />Attach four 14) copies of plans f�� proposed work � Draw to scale and note the following as applicable: <br />• Properly Lines • CeNedine of street <br />• Outline and dimensions of all existing antl • Indicate North <br />pro0osed stmctures on the lot • Show� any proposed grading changes <br />• Existing and pwposed ulilities • Show measurem�nts <br />PERMIT CONDITIONS <br />1. All calls for Inspection shall be made 2J hrs. ir advance- phone 25J-88�0. <br />2. All work shall be perlormed in accordance w�;`i this permit and current City ol EvereU Design and Construction <br />Standards and Specitications. <br />3. Call Location Underground Scrvice 48 hrs. before you dig. TOLL FREE NUMBER 1•$00•424•5555. <br />q. �}�S p�7-C c��vorTl�� oF ,�;� .���vZ_� 3�5/ <br />_��X ��l �� �{-ZZ- 9Z <br />Ap roved lor ConslruFtion � �ate <br />it%j � <br />/,- <br />� �� �>:�, ,a _��. : Z <br />FINAL INSPECTION � Date <br />Approved as Constructed <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Sireet <br />Everett, WA 98207 <br />Phone: 259�8G70 <br />W <br />H <br />N <br />� <br />0 <br />ACKNUWLFDGF.W�'d i � � f,ONDITIONS <br />l h:e �,.rAr�rsigrr.t xvner/applicon: `io�•�n� a�reec �o hold and : ave h2rm� <br />�as�; wc C r; ;� Fe_wett :rom .�ny and aG ch�n,:. .:- 9.n-,:�9ea �:osis. <br />ce;.rmse; or esuses of acbon chat may t�isa beca�se of installat�or� <br />actl maic:enance ol the improvement ur other righhuf�way use hersto <br />appi�cA ior and turiher agiees lo remove same upon notice irom the <br />� rCity antl to replac publ��c pioperty damaged thereby. <br />� � � /� <br />V <br />k ` ,>� 1,..,,--�/ � � -�'2 <br />Sig at�e ol Applicant ate <br />WORK AUTHORIZED BY THIS PERMII M�I.ST BE STARTED WITHIN <br />i8C DAYS OF Dl.TE PERM17 IS ISSI1�0 AND THEREAFTER IS TO <br />BE DILIGENTLV PURSUED TO COMPLFTION. THIS PERMIT �AAY BE <br />�:ANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PRO!ECT OVER 90 DAYS DURATION. <br />