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. r�m��wo�ksvo��,�i• ��I IZ� � <br /> Dale i <br /> ' i� oiaa oaoi ._91/sfi@@6 —_- <br /> � � Applicalion For <br /> PUBLIC V�IORKS PERMIT PW�icWoihaFee <br /> p' p toini Feo s - <br /> C ~ le5a ROG�Fee Paid $ <br /> � H N <br /> � M TO POSTING__�;. , ;,,, �'�°°°F°°` 5 Zo- <br /> � y �n Print or Type ONy -� • , <br /> °w � ro <br /> N M <br /> � zp � Alden R Heitman 17814 - Bth NW Seattle 98177 596-3010 _ <br /> � M Owner Mailing Atldress City Zip Fhnne <br /> � `� � Owner <br /> y y � Applicanl MailingAddress Ciry Zip Phone <br /> t+ z <br /> N H <br /> � d y Descri6e Proposed Work _Ca CFR — <br /> � ro r Y. . �:�,,, �__��.�_., <br /> Hovyi �• <br /> I1000c^669b � <br /> ProjectAddress�ilknown) 1712 Edgemoor Larte FIF'+ 51�f1.i16 � <br /> �E'LI'� �14�.��� �� <br /> Attach fow(4�copids ol plans for proposed work- Draw lo scale and note the following as applicsble:FLN CN £9.,.� � <br /> • Property Lines • Centerline al slreet � y_� <br /> • OWline and dimensions of all existin9 and • Indicate North F SF.�H 9� <br /> proposed structures on the lot • Show any praposed gradiRB�bnges '�-0.Q0 <br /> • Existing and proposed utilitie^ • Show measurements �OOt�1�7259 M <br /> W <br /> DO NOT WRITE BELOW THIS LINE EF000��8�'�Q-: � <br /> PERMITCONDITIONS Jc'�E� 4���(�n <br /> 1.All calls lor inspection shall be made 24 hrs.in advance•phone 259-8810. 1171-5 "•'�<<.�� � <br /> �����, 2.All work shall he pedormed in accordance with this permit and current City ol Everetl Desig,ry�;Con6tjg011q�.Q <br /> � = StandardsandSpecitications. <br /> 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1•B00•424•5555. � <br /> i <br /> I �-_ q. �.�� S�OP25 S`lZl� Y70't 2XC.�d� 2 � L'�Ov i201��."�c.� to � ��/`l'.�^-��C.2.�� Q <br /> �� -For par�nzv�eht -(-:�•;sheca 9✓'ades. �Y <br /> I"� <br /> I � ; � <br /> .,. :. � <br /> �• � • 4 � <br /> S <br /> iv tl 'N. lei l <br /> f__ H�,.' . . . .. � <br /> R* <br /> � . <br /> '�' 1iS:: <br /> �' �}}�, <br /> �4, a4�i' <br /> `� =�=' � ACKNOWLEDGEMENT OF CONDITIONS <br /> I The undersi9ned owncr,'applicant herehy agrees to hold and save harm� <br /> less Ihe Ciry of Everetl Irom any and all claims lor damages, costs, <br /> i <br /> expenses, or causes ot action ihat may arise because of instal ation <br /> �o � � � �A A _ C�_c�1 and maintenance ol Ihe improvement or olher right�of�way use herelo <br /> �-t applied lor and luriher agrees to remove samc upon notice �rom the <br /> ��' Date <br /> Approved lor Consir�clion City and to replace Gublic property damaged thereby. <br /> � , /. <br /> �'L � <br /> i'( ;��:- ::•=--- L•-/- � �%�-i, //!/;,t� �. <br /> FINAL INSPECTION �a1e i D.�le <br /> Approved as Consiructed Signalure ol Applicant <br /> � WORK AUTHORIZED BY THIS PERMIT MUST �E STARTFD WITHIN <br /> PUBLICWORKSDEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTEii IS TO <br /> 'r� 3200CaderStraat BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Everelt,WA 98201 C�NCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259•BB10 pROJFCT OVER 90 DAYS DURATION. <br />