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i <br /> � � � <br /> � � x <br /> C H <br /> 9HU� <br /> rm> �=)-7 _ <br /> y 'z � Date �„��.<<:��,...��..�,�.�. _�Z�'�� <br /> 3-13-92 <br /> '� y � e�:.� o.>i . 359G4-- -- <br /> � H � Applicahr.n For AIC... . . ` — "__ <br /> 0 PbSTlir� y'; . '�>z <br /> yrp� �' " PUBLIC WORKS PERMI'T -` �""""°„"" <br /> ro���«o s-- <br /> L-_ � � . less nani Fre Pa�u S ._ <br /> H C7 � oaimce o„o S_ _ <br /> � n Print ur Type Only --- <br /> �� g <br /> � <br /> y y� Select Nomes 237 Elm St � � Bvcre[t liA 98203 Randy Clark 258-1503 or <br /> t� �y y O�mer MaJing Addre55 GtY , <'P PhonC 348-1320 <br /> �� <br /> H <br /> ❑ty[n Owner <br /> � [�� Applicant Mailing Adtlress Gty ZiP Phonc � <br /> H O� new construction Lot 72 Maple A107 ' � I <br /> Describe Proposed Work <br /> W <br /> Piolect Adtlress(d knnwnl �� — �S � �2 S'� — � <br /> Att�ch low�4)copies of Plans b� propo5ed work� Dmw�o scnle anef nme ihe following as applicable: �r <br /> • Property Lines • Centerline of s�reet � <br /> • Oi tl�ne and dimensions oi all exisling and • Intlicale Norih <br /> proposed slructures on Ihe lot • Show any proposed 9radiny chanpe; <br /> • Existing and proposed utildies • Show measuremenis � <br /> / <br /> DO NOT WRITE BEIOW THIS LWE � <br /> I �� PERMITCONDITIONS <br /> 'i 1.All cails lor inspeclion shall be made 24 hrs.in ativance-phone 259-851 O. w <br /> 1 • 2 All work shall be pertormed in accordance with this pennit and curren�City ol Everett Desi9n and Cons�rur,�ion ♦ <br /> � Stantlards and Specifications. <br /> ' � 3.Call Location Ucdergmund Service 48 hrs.belore you dig.TOLL PREE NUMBER 1-800•424•5555. � <br /> •�.�.� .1 . lrit�r�� ll r���Y. ���nst.ru�t.i�n rnitrnnr•a }�n},iuri riri����wn�� -�:�� r,..r r.it.�� <br /> . r-:i.�,n�?;n•rl II:?�lR smrl ��t•n:-inn rnntrnl ns ,.3ir�-.ri.,,,-i 1-,�� T'nl�li,, ld��rl � <br /> Tn:�PecT.nr. . . . <br /> F. . rieep r,itY �treets r7ean at al. l. times <br /> i .�� �, . �"'iirh eutt.ar and sidewalk in the vlat �l^e rew and undams�cri . � <br /> ' nnv dama@e therPto shal7 be rPplaced at Y.he discretion of rli, <br /> Vnblir Wnrkz In;;pr-,r.tor. /A <br /> i . Any r_hane� in the drivr_wav r.ut must be approved by the PP7 i: N♦ <br /> ��,�� :;pFctnr, wi�ith at prop line limited to e+:istin� aFron wir3� ii. O <br /> '�. Connect. all roof. y�rd and drivewav drai.ns to storm dr:+ in <br /> sv�tam vrnviderl Y.r> lnt. ^ <br /> / '1. Ad.iust, wat.er hn:tee t.� err,rlr; at end �f ��n,tructi^❑ . ��� <br /> � ,��� i�i. ih•ivewav� :;hall be r,om��letel:� cni�r��1 h��±'„re dri�. inc �n t.hF�in. <br /> � �`n <br /> � ACKNOWLEDGEMENT OF CONDITIOiVS <br /> \' + _— \ V —' —'__——_ <br /> ihe unde�siynetl owner/applicant heroUy aqmes Io hold nnd sa�����;�iin� <br /> ��� -- � less Ihe City ot Everett Irom any and all claims lor dania9es. ensL: <br /> ./� expenses. or causes o� action that mny arise because ot mstallauon <br /> /� '�/I� � — '7 �jn and maintenance nl Ihe improvement or other righPof-�vaY use here�o <br /> V . ' •' Y �Q�. L�— " appfeA for anA lunher ae�rees lo remave same upon notir.e irom thc. <br /> Appiovetl �slru::l�on ���E' City/�nQ lo�ppl ���_,��U/hc proqe�ty damaged Ihereby. <br /> '� � �/.L(,C�� 1` ��//L�/J ! l�tc� <br /> � /� • l / /�/�(.///��" ) <br /> � .__ ll �•�� /�`_ � �� � � �J� �n� 1�4C'✓f'`• �/ '� ���C/ <br /> FINAL INSPECTION Datc .�( �� • //� <br /> Approvetl as Construc�ed Siyna ure of Applicanl ���" <br /> � WORK AUTHORIZED BV THIS PERMIT h1UST BE SiARTED WIIFIIN <br /> /tly� PUBLICWORKSDEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUGD AND THEREAFTER i., LO <br /> � 3200Cedar5lreut � BE DIUGENTLY PUPSUED TO COMPL[TION. THIS PERMIT M4Y P[ <br /> Evercl6 WA 98201 CANC[LLED RV 1HE CITY UPON ANV STOPPAGE Of WORK ON 1HIS <br /> Phonc:259�HHt0 PROJECT UV[R 90 DAYS DURATION- � <br />