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� APPlication For <br /> PUBLIC WORKS PERMIT Date_6_p�_gb ,� <br /> PUBLIC WORKS DEFARTMENT Public Works Permit# �J �p �5 <br /> 3200 Cedar Street <br /> Everett,WA 96201 259-8810 � <br /> �'!� POSTING '� 1 8 � BuiltlingPermitp 52116 <br /> TYPE OR PRINT ONLY — e � <br /> Public Works Fee$,_�c.rv � <br /> Reese Rick/Bonnie 1O8U3 lst Ave SE Everett 98208 347-5869 <br /> Owner Mailing Address <br /> City Zip Phone <br /> Owner <br /> Applicant Mailing Address <br /> City Zip Phone <br /> Describe Proposed Work detached garage <br /> W <br /> F- <br /> — <br /> �T � k <br /> PROJECT ADDRESS(ifknown) 10803 lst Ave SE � � <br /> .,,, W <br /> Attach(ou�(4)copies of plans Ior proposed work-Draw to scale and note the lollowing if applicable: Eg�p��^� 8145.� <br /> •Property Lines butline and dimensions of all ezisting and propo�ed simctures on the lot •Existing and pyppSQ�'utilities $4.50 O <br /> 'Centedine o1 street •Indicate Norfh •Show any proposed gratling changes •Show measuremeNs UR.I6'W' ;�Q,�(1 <br /> PLbI CH �b7.15 � <br /> DO NOT WRITE BELOW THIS LINE , 1 , <br /> PERMIT CONDITIONS: <br /> 1.All calls for inspection shall be made 24 hours in advance- phone 259-8810, Z <br /> 2.All work shall be performed in accordance with this permit and current City of Everett Design and O <br /> Construction Standards and Specifications. <br /> 3. Call Location Underground Sarvice 48 hrs, before you dig. TOLL FREE NUMBER 1-800-424-5555. <br /> 4. l� sta 11 /L'' N/2 Gul ve� un o� d�rLti�,.a�, ~ <br /> - �d,��� � <br /> i�+ n,t h 6 " �r v t k�d b�+c,�?/ � n�,H Iz• ov�. /n s f n c/ O <br /> c..b. � G,.,10-f' cv�c. �o�ve l�xr'�fl3,� l�.c� -�,c. a' <br /> dr�u�c�.� �,,,r �ye o�' � <br /> �oa�.c.�.� .L, �ow � P.��' �,,e. <br /> �,1�,61�� <br /> / /� ACKNC�NLEDGEMENT OF CO4DITIONS <br /> �� //�/r�[/_ �///�� The u�ersigned owner/�pplicant hereby agrees to hold and save harmless <br /> ��� /-•P�„ ihe Cit o(Everett irom any and all claims for damages,costs,expenses,or <br /> Approved r Consiruchon a�e causes of action that may arise because of installation and malntenance of <br /> ihe improvement or other right-of-way use hereto applied lor and further agrees <br /> / to remove samo u on notice from the City and to replace public property <br /> _�s�� �//y� amagedthereby. P <br /> FI AL INSPECTI91 �Date '� <br /> Approved as Consiructed <br /> i � � <br /> nature ol Applicant �e <br /> K'ORK AUTFIORIZED BY THIS PERMIT MUST BE STAflTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS TO BE DILIGENRY PURSUED TO <br /> COMPLEf10N.THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPqGE OF WORI(ON THIS PROJEC70VER 90 DAYS DUAATION. <br />