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Date a�csaw,,.sa:.:T��. _�_ <br /> Applicatlon For aioo.o�c�• <br /> PUBLIC WORKS PERMIT P�DTo1�FaaFe� : <br /> l ess Auo�Fee vata S <br /> Print or Type Only e,u�o.o�. S <br /> Plan Check No: B 47918 SEPA <br /> Applicat.Date: 03�31/95 <br /> Job Address: 62 2 2N0 DR SE <br /> Owner: YEATON CHRIS/KIMBERLY <br /> Owner Tenant: p Phone � <br /> Proposed Use: SINGLE FAMILY RESIDENCE <br /> Desc, of Work: <br /> ADD 80NUS ROOM 180SF <br /> - AppliCant p Phone <br /> � OFFZCE SET JOB SET <br /> Describe Proposed Work _ APPROVED FOR PERMIT: DATE_/_�_ �y <br /> W <br /> Pro(ect Address(it known) � <br /> Attach four(4)copies ol plans for oroposed work-Draw to scale and nole the Ioilowing as applicable: � <br /> • Property Lines • Centerline of street ,w <br /> • Outline and dimensions of all existing and • Indicate North V� <br /> proposed structures on the lot • Show any proposed gra0ing changes <br /> • Existing and proposed utllities • Show measurements � <br /> DO NOT WRITE BELOW THIS LINE ' <br /> PERM�T CONDITIONS O <br /> t.All cails for inspection shall be made 24 hrs,in advance•phone 259•8810. � <br /> 2.All work shall be peAormed in accordance with this permit and current CHy of Everett Design and ConstracUon <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 /> �w <br /> %UBLIC WORKS PEp1,li* �/ ' <br /> !�Of AECUIREP �/ <br /> °r A.,y� _.3 %s O <br /> /-�-_---..�._... <br /> .>T�- �.P_�_. a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicanl hereby agrees to hold and save harm- <br /> iess lhe Cily ol Everet� Irom any and all claims tor damages, costs, <br /> ' ezpenses, or causes of aclion that may arise because of instailation <br /> and maintenance ol lhe improvement or other righFof�way use hereto <br /> applied for and fuhher agraes to remove same upon notice from the <br /> Approved lor Construction Date City and to replace pubiic property damaged Ihereby. <br /> FINAL INSPECTION Dale <br /> Approved as Constructed Signature ol Applicant Late <br /> PUBLIC WORKS DEPARTMENT W�RK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200CedarSlreet 180 DAYS OF DATE PERMIT IS ISSUED AND THERFAFTER IS �TO <br /> Everetl,WA 98207 BE DILIGENTLY PI�RSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone:259�8810 CANCELLED BYTHE SITY UPON ANY STOPPPGE OF WORK ON THIS <br /> PROJECT O��ER 90 DAiS DURATION. <br />