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�8t@� PUCLc Worka aermil r ✓ � ��/ <br /> Apolication For emB.oeoc.n_. r �y .3 <br /> PUBLIC WORKS PERMIT PueTotalFeaFae s <br /> Wss ApD��Fee PeiC S <br /> Batann!Due s �G'-Da <br /> Print or Type Only _ <br /> ��9sa <br /> Boyden Realty, Inc. 1429 Rroadway Everett 98201 252-1166 <br /> Owner Mailing Address City Zip Phone <br /> J & D Builders 1429 Broadway Everett 98201 252-1166 <br /> Applicant Meiling Adtlress City 2ip Phone <br /> Describe Proposed Work . Ne�r Sinzle F�mily Residence <br /> � <br /> — -- ys�vs� � <br /> Project Address pf kn,,.�n) � lat Drive S.E. Everett � <br /> Attech four(4)copies of plan5 for proposed work- Draw to scale and note Ihe following as applicable: � <br /> • Preperty Lines • Centerline ol slreet � <br /> • Outline and dimensions of all ezisting and • Indicate North <br /> proposed structures on the lot • Show any proposed grading changes <br /> • Existing and proposed utilities • Show measuremenis � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS O <br /> 1. All calls lor inspection shall be made 24 hrs. in advance• phone 259•881 5. � <br /> 2. All work shall be perlonned in accordance with this permit and current City of Evere�t Design and Construction <br /> Standards and Specilications. <br /> 3. CaII Location Underground Service 48 hrs. before ynu dig.TOLL FHEE NUMBER 1•$00•424•5555. � <br /> O <br /> � <br /> N <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The unders��ned owneUapphcant hcreby agrees to hold and save harm- <br /> less Ihe ' .ry ol Everett irom any and all claims lor damages, cosis. <br /> eapensca or causes ol action that may arise because ot installation <br /> n and maintenance ol �he improvement or other right-ol•way use hereto <br /> ` J 4> ��''� � c� applied lor and further agrees to remove same upon notice Irom the <br /> Approved for Con �uction ate Ciry and to replace public property damac�ed thereby. <br /> `i-i.,� <br /> /�.�.� � � / / <br /> ^^,`^ ..� C � � .��— <br /> FINAL INSPECTION Date <br /> Approved as Constructed �Sivnature of Applicant Date <br /> everett FUBLIC WORKS DEPARTMENT W�RK AUTHOHIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> � 3200 Cedar Street 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett,WA 98201 BE DILIG[NTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone: 259-BB15 CANCELLED BV THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJCCT OVEf;90 DAYS DURATION. <br />