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- �- �-2�-4 ����/�/�' � <br /> Date e-19-93 PuOtic Work�Permn� ___('��T'^'�_ <br /> Application For ema.oeo�-•�S4 <br /> PUBLIC WORKS PERMIT PuOi�cWorksFee <br /> Tot�l Fee s <br /> Lesa ADO�Fee PeiE S <br /> Print or Type Only e.�,�ao�a • �-�� <br /> � <br /> Colony Craft 14410 Bel Red Rd Bellevue WA 98007 644-2323 ' C <br /> Owner Mailing Address City Zip Phone �--� <br /> Owner <br /> Applicant Mailing Address City 2ip Phone <br /> . d <br /> Describe Proposed Work rockery Za <br /> 1 <br /> ,a,,,�. W <br /> Project Address(i(known� 5627 lst �SE Lot 40 Hanabrook 2 � <br /> � Altech low(4)copies of plans br proposed work• Draw to scale and note the following as applicable: � <br /> • Property Lines • Centerline of street � <br /> � Outline and dimensions of all existing and • Indicate North <br /> proposed structures on the lot � Show any proposed grading changes <br /> • Existing end proposed utililies • Show measurements � <br /> DO NOT WRITE BELOW THIS LINE O <br /> � PERMITCONDITIONS <br /> 1.All cells for Inspection shell be mede 24 hrs.in advance•pho�e 259�8810. � <br /> 2.All work shall be pertormad in eccordence with this permit end curcent City of Everett Design end Conatructlon <br /> Standerds end Specificetions. <br /> 3.Cell Location Underpround Service 48 hrs.betore you dlg.TOLL FREE NUMBER 7•800-424•5555. � <br /> �, ��i �7GV ��(.'%�,��' -Fi�1 ��� c�r���- ��(c`!3 O <br /> � <br /> � <br /> O <br /> a <br /> ^� ACKNOWLEDGEMENT OF CONDITIONS <br /> ��� The undersigned owne�/applicaM hereby agrees to hold and save harm• <br /> less Ihe City ol Everett Irom any and all cleims for dameges, costs, <br /> ! ezpenses, or causes of aclion that may arise 6ecause of instellation <br /> l !? 'M�( O�� G/� ��r3 and maintenance of Ihe improvement or other right-of•K�ay use �ereto <br /> ��.- ' l r�` applied lor and further agrees to remove same upon notice Irom the <br /> Appro d lor Construction Dale Ci�y and to replace Public property damaged thereby. <br /> �iCS�Gu�_ /o-if-g'7 <br /> FINAL INSPECTION Date S� <br /> Approved as Const�ucted Signature of Applicant a�e <br /> � PUBLIC WORKS DEPARTMED'T WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200CedarStreet 180 DAYS OF DATE PERMIT IS ISSUED AND THEflEAFTER IS TO <br /> Everett,WA9B201 BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Phone:259�8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WOFK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />