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� N 2� 2a .¢ <br /> y. Applicalior For j <br /> PUBLIC WORKS PERMIT Date 5/31/96 <br /> TO STI NG � j Q �� �BLIC WORKS DEPARTMENT Public Works Permit# �71D �Z�B <br /> 3�00 Cetlar Street <br /> �yerett,WA 98201 259-8870 <br /> � Building Permit M S 1 RFiF <br /> � ogv�i �, o � C"S :+ �^ <br /> TYPEORPRINTONLY d PublicwoiksFes;�iv�' <br /> �n r ri o .� o o -o n + <br /> �' P1 �il �O M Cd [� [T t0 L� <br /> f� u1 M bl M c4 CJ t^� Cd <br /> ANTHONY HOP � �� rJ <br /> Owner ��173RD ST �ARTafN('Tf1N 9A � 755-9412 <br /> Mai g.(� ess � -_ p > HCity Zip Phone <br /> � tf1 p� 3 M (i IJ N ` <br /> W O H I_1 <br /> CJ O �C�,I, � t=j (�j � 3 �� O W <br /> O J W p' f; O� W n ,� � <br /> Applic::nt Mai `g Adtlress City Zip Phone <br /> Describe Proposed Work NEW HOUSE � <br /> � <br /> PRUJECTADDRESS(if known) 7 03� 1 s� Dri S� � <br /> Attach four(4)copies of plans(or proposed work-Draw to scale ard note the lollowing if applicable: � <br /> •Property Lines 'Outline and dimensicns of all existiny and proposed structures on the lot •Existing and proposed utilities O <br /> •Centedine o(street •Indicate North •Show any proposed grading changes •Show measurements <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS: � <br /> 1.All calls for inspection shall be made 24 hours in advance- ohone 259-8810. <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 Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � <br /> �. Iteotiop draivaee shell bo dischm•ged: �/• <br /> • l'o Ihe site's slonti ch aiu system (priv.de or public) O <br /> • To Fi residenfi:il roofdu�v�u�pout ;y,tem de,igicd per seclion 4-9.a of Ihc a <br /> cit}�slvidards <br /> • Onto splash blocks <br /> 'flie nie.lhod sel�+cled will be su�jecl to Pui,lic 6Vark.;luspector sipproval. <br /> �If�" � <br /> �/� ACKNOWLEDGEMENT Of CONDITIONS <br /> /f�� —� � �� The undersigned owner/applicant he�eby agrees to hold and save harmless <br /> /�� the City of Everett Irom any and all claims(or damages,costs,expenses,or <br /> Approvetl �onstluction ate causes of action that may arise becausa of installation and maintenance of <br /> � the improvement or other right-ot-way usa hweto applied for and further agrees <br /> / i� � to remove same upon notice trom the City and to replace public property <br /> y�_ ���i���t�`�_//�/'3��� damaged thereby. <br /> -INAI IN PEI, I N v Dat , <br /> Approved as Constructed - <br /> �..,._ „� <br /> Signature of Applicant Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF OATE PERAIIT IS ISSUED AND iNEREAFfER IS TO BE DILIGENRY PURSUED TO <br /> COMPLETION.THIS PERMIT MAY BE CANCELIED�Y�RIE CIN UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />