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�? (� r ��(j, <br /> �a�e � '2 � L5 l9 � (� �f L �Pu lit Works Permil� �� �� L <br /> ' 83�/.�773 <br /> gi v.Oeot• <br /> Application For D c C 1 �' 1983 - <br /> PUBLIG WORKS PERMIT PublitWorksFea <br /> x . �� ,� <br /> Tolal Fee $ -- <br /> ......�..................... <br /> ��"""""" ..Loss Appl Foe Peid S_ <br /> ................. <br /> cirY oF rv�REr� ae�e��oo�a s �� � ��� <br /> Print or Type Only '�-:`= 1".'_rks p,,:,. �E� <br /> Boyden Realty, Inc. 1429 Broadway Everett 98201 252-1166 <br /> Owner Mailing Address City Zif Phone <br /> Boyden Realty, Inc., dba .I & D Builders, 1429 Broadway,Everett 9f1201 252-1166 <br /> Ap;licant MailingAddress City Zip Phone <br /> Oeccrihy Proposed Work Ne�R6]e Familv Residence <br /> �u <br /> Prolect Admass(it known) 951^ 9nd Aven� P ^ F EveretL�r 1 im n�ry � � <br /> A�lach four(4)copies o!plans lor proposed work- Draw lo scale and note thc lollowing as applicable: � <br /> • Properry Lines • Cente�lina ol sireet ♦A <br /> • Outline and dimensions of all existing and • liidicate North V� <br /> proposed siruclures on the lot • Show any proposed grading changes <br /> • Existing and proposed uUlities • Show measurements M <br /> W <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1. All calls lor inspection shell be made 24 hrs. in advance- phone 253•881 5. � <br /> 2. All work shell be performed in accordance with this permit and current City of Everett Design and Construction <br /> Stendards and Specifications <br /> 3. Call Location Underground Service 46 hrs.belore you dig.TOLL FREE NUMBER 1•800•424•5555. � <br /> O <br /> � <br /> � <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONOITIONS <br /> The undersigned owner/applican�hereby aqrees to holA and save harm• <br /> less the Cily of Everett irom any and all claims for damages, cosis, <br /> �—� �� �/ ezpenses, or causes of action ihat may arise because of installation <br /> � ��� `J j / and maintenance of �he Improvement or other righ4of-way use hereto <br /> %'��/� ( �L f� applied for and further agrees to remuve same upon notice Irom ihe <br /> Approv lor ns ruction � �'a�� City and to replace public property damaged�hereby. <br /> _ � �' .-- �' � �c%/S �'.� <br /> FINAL I PECTICN Date �'�'"" <br /> Approved as Consiructed S�igna�ure ol App:icant � ate <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> e��erett PUBL�C WORKS DEPARTMENT 1B0 GAYS OF DATE PERMIT IS ISSUEO AND THEREAFTER IS TO <br /> � 3200 Codar Street BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> E reret�,WA 98201 CANCELLGD 8Y THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Pnone: 259•8815 PpOJECT OVER 90 DAYS DURATION. <br /> I <br />