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Date 6-26-95 � I� 2`� /`� � <br /> 4 PubL[LYO�LS Pnrmil• �y�/�._ <br /> Application For � ��ari o�•ni . .__48.724---- —_. <br /> PUBLIC WORKS PERMIT �������=,V���=�, ---- <br /> .�„���,. s <br /> Les,nnni F�,�. r�.��e S_ <br /> Print or Type On� pQSTING �_____, � ' e,�.��,.o,,. s�� __ <br /> Michael Hancock 9306 lst Ave SE Everett 98208 353-4267 <br /> owner Madinq nN.druss C�Iti'. � �'; Zin rnn��n -- <br /> ' ' ,� �� . . . . �. <br /> Owner � . � � <br /> APPlican� O::dliqn AAdress --�.---. Citv ZiP —_ __ Phon�, _—�_ .- —. <br /> Describe P�onos�d�vork __ neW house ____Lot 1 of SP i11202-15-89 <br /> q3_D_�- ---------------- W <br /> ProlectAtldressi�lknown; ��_15t AVE $E _ _ __ ________ � <br /> Atlach lour 141 coP�es ol plans to� nwP�sed wo�n - Drav ;o >c,i�...�nn ncte the loilcwing as anUhr.ah�e. � <br /> • PrOperty LineS � Cunterhnn n1 streel � <br /> • Outhne and aimensions o�all c<�sting an:! • Indir.�le Nonh <br /> proposed slructures on the loi • Snmv,ny r.roposed pratlmq r.hanaF�s <br /> • Existing and proposed utilities • Show measurr.menis � <br /> 00 NOT V�'RITE fi[LON' fHIS LINE <br /> PERMIT CONDITIONS O <br /> 1.All calls for inspection shall be made 24 hrs.in advance•phone 259•8810. � <br /> 2.All work shall be pedormed in accordance with Ihis permit and current City of Everett Design and Construction <br /> Standards and Specilications. <br /> 3.Call Location Underground Service 48 hrs.belore you dig.TOLL FREE NUMBER 1-800•424•5555. � <br /> O <br /> � <br /> � <br /> O <br /> a <br /> � ACKNOl9�LEGG[PdENT OF CONDITIONS <br /> _ �!' y Thn��ndr.rbi�netl o�:neVapphcant he�eby agrees Io holtl and sace h�rm� <br /> 1 - - --�� i��ss ;hr Gty d [va�ell Iwm any antl all clalms for dama9eti. ,;osts <br /> i Pvpen5e5. o� Causes of aCliOn ihat may ans? beC�use ol in5lallntion <br /> C � s/�7�' � and miinten;tnce n! Ihp improvement Or other nghPof�way use hr�reto <br /> J _ � ipphr.d lor nnd furiher aqrees to remove Same upon nonce Irom Ihe <br /> APP v _/to Co� ion D�I�' C�:v anA m mplaco nublic proneiry damaged thereby. <br /> / I /� � / <br /> FI AL INSPECTIO aI� I .�/�/Ai�r�/ u //V4�l.t� �%v� <br /> Approved as Constructed SgnatwrlofApphcan! � Date <br /> ���� PUBLIC WORKS DEPARTMENT INORK AUTliORIZED B1 THIS PERIAIT MUST BE STARTED WITHIN <br /> 3200CedarSlreet I �AO DAVS O� DA7E PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everelt.`NA 98201 BE DILIGENTU' PURSUED TO COMPLETION. THIS PERMI7 N,AY BE <br /> Phone: .9�8810 � CANCELLEO B'I THE CITY UPOM ANY SiOPPAGE OF WORK ON THIS <br /> i PRQiECT OVER 90 DAYS DURATION. <br />