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Date_ 3/17194 � �'0 POSTING T- 7� �� ti °°°°°"'°'".P���,�,�4� • <br /> Applicetion�r eiaa.oeo�.• <br /> PUBLIC WORl�S PEl�MIT PuoTotalFeeFee s <br /> OLess Appl.Fee Paid S� <br /> 0 p Q Q � Belance0ue S <br /> PrintorTypeOnly Q v�i8 � o �i � � � odo <br /> � .� rioo � ri .+ vi ovior�� <br /> O O �U V] e+ tl� CJ -+ O � NIl'1IV <br /> VIMM M M tl1 .+ N L� v7N <br /> Nancock Mike 9306 lst Ave S� Ev�rrett 98208 � �5�-42b°7"� «� <br /> Owner Mailin �AArt�s � � �C k � � H � U�ip Phone <br /> Same � � � � � 3S� m � �' � � rt"ia�`i � t5 <br /> Applicant Mailing Address City Zip Phone <br /> Describe Proposed Work <br /> New house <br /> W <br /> Prolec�Address(if known) �220 ��A�`� Lot 1 S.P. 14-89 � <br /> Attach four(4)copies ot plans for proposed work- Draw lo scale and note the lollowing as appliCable: � <br /> � • Property Lines • Centerline ol street � <br /> • Outline and dimensions ol all existing and • Indicele North <br /> proposed structures on the lot • Show any proposed grading changes <br /> � Existing and proposed utilities • Show measurements � <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1.All calls for Inspection shall be mede 24 hrs.in advance•phone 259-8870. � <br /> 2.All work shall be performed in accordence with this permit and current City ol Everett Design end Construction <br /> Standarda and Specifications. <br /> 3.Call Locetlon Underground Service 48 hrs,belore you dig.TOLL FREE NUMBER 1•800-4245555. � <br /> O <br /> � <br /> � <br /> � <br /> � <br /> L,/, � _ ACKNOWLEDGEMENT OF CONDITIONS <br /> '�'(L The unoersigned owner/applicant hereby agrees to hold and save harm� <br /> —��f� less the Ciry of Everelt from any and all claims for damages. costs, <br /> ,/�/f �7 / e■penses. or causes of aclion that may arise becaus= ot installation <br /> / 0//�/�� � and maintenance of the improvement or other righ4of�way use hereto <br /> � 4iV applied for and furlher agrees to remove same upon notice f!om the <br /> Approved Io�Gbnstruction /�'a� City antl to replace Public property damaged thereby. <br /> l / <br /> i / <br /> ,n� / �3/99 �/� � � <br /> FI�INSP,_ T Ot� � D fe —7��,�_ <br /> Approved as Const•ucted �onatu e ol App icant ' F'oie <br /> /AI� PUBLIC WORKSDEPARTMENT RK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200 Ceder Street 8E DILIGENTLY PURSUED TO COMPLETION.�fHIS PeAMIT MAY BE <br /> Everzit,WA 98201 CANC;ELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259�0810 PROJECT OVER 90 DAYS DURATION. <br />