Laserfiche WebLink
R'' �GSTING NOV 12 1997 <br /> �e;,��� APPlication For � / <br /> PUBLIC WORKS PERMIT Date 6-4-9i <br /> PUBLIC WORKS DEPARI'MENT Public Works Permit q _��j�' '� <br /> 320D Cedar Sireet <br /> 'cveretl,WA 98201 253-8810 <br /> Building Permit k_55345 <br /> T'PE OR PRINT ONLY Pub!ic Works Fee S_� <br /> Alfred Jnbie lis�: 19th Dr Mukilteo 98275 290-1456 <br /> Owner Mailing Address Ciry Zip Phone <br /> Owner <br /> Applicant Mailing Addiess City Zip Phone <br /> Dascribe Proposed Work new house <br /> W <br /> _ H <br /> - <br /> PROJECTADDRESS(if known) 1 i I o 7 9 � �Ave � <br /> Attach(our(4)copies of plans lor proposed work-Draw to scale aM note Ihe(ollowing if applicable: � <br /> •Property Lines •Outline and dimensions of all existing and Froposed structures on the lot •Existing and proFosed utilities O <br /> •Centerline of street •Indicate North •Show any prop�sed grading changes •Show measurer�p{�o-t� u�3� � <br /> DO NOT WRITE BELOW THIS LINE g�IIDIFK'i 672.70 <br /> PERMITCONDITIONS: I� �.� � <br /> 1. All calls for inspection shail be made 24 hours in advance- phone 259-8�����.� O <br /> 2.All work shall be performed in accordance with this permit and current Ci S and <br /> Construction Standards and Specifications. ppRR <br /> 3. Cali Location Underground Service 48 hrs before you dig. TOLL FREE 1���1-8�4-5555. � <br /> ` ' HNTER 650.00 �/� <br /> N 31141 V♦ <br /> SEth]t 70.00 0 <br /> UTILITY OEV � <br /> ]296.00 <br /> BJFD ili 330.00 <br /> 70TAL 316630 <br /> GHEK . <br /> A OR 703 <br /> ,k� <br /> A(:KNOWLEDGEMENT OF CONDITIONS <br /> �V� ��/��7//J a/,�pp � /�/7 The undersigned oNnedapplicant hereby agrees to hold and save harmless <br /> C��C^;,,�✓'� � (""^� (Y /� � ihe Ciry of Everett from any and all r.laims for damages�costs.ezpenses.or <br /> Appioved or Conswction Date causes ol action Liat may arise because ol installation nnd maintenance of <br /> � theimprovemenhrotherright-of-woy heret � dlorandfunheragrees <br /> to remove same upon otice tr t e it and to r lace public property <br /> � /� —�� damag t e ��. � <br /> FINAL INSPECTION Datc <br /> Approved as Constructed / � <br /> /rf��� <br /> V <br /> Sign ure of Ap ant patc <br /> WORK AUTHORIZED 6Y THIS PERMIT MUST BE STARTEU WITHIN 180 DAYS OF DATE PERAIIT IS IS ED AND THEREAFfER IS BE DILIGENTLY PURSUED TC <br /> COMPLE710N.I�HIS PERMIT MAY BE CANCELLED BV THE;ITY UPON ANY STOPPAGE OF WORK��THIS PROJECT OVER 90 AYS DURATION. <br />