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v ia� <br /> puelic worMa Perm�t� � �_ � <br /> ./ L <br /> UB�e 1 y/ BiCGDeol.n <br /> qpplication For P„pi;�wo� �Z O• d__�_ <br /> PUBLIC WORKS PERMIT ToulFee <br /> �ese noc�Fee Pem s ------- <br /> S �J.00 <br /> �e�ence ouo <br /> Print or Type Only ` �5 �,7� <br /> Everett 98201 252-1766 <br /> Inc. 1429 9roadwa �.iY Z�P phone <br /> Boyden Realt , Mailing Address <br /> Owner <br /> Boyden Realty, In�• Everett 48201 252-1166 ___ <br /> dba I & D Builders 1429 Sxoadcaay — Z.p phone <br /> qpplicant <br /> Mailing Address City <br /> Dcscribe Proposed Work New SinQie Famllv����-'' <br /> _ -------- W <br /> ot17 2nd Pr �� S Evess=*r ---- � <br /> prolect Address(il knowc) �----- �� <br /> Attach four(41 copies of plans lor proposed work- Draw�o scale and note�CQo11e line oi st�eei'ab�e: I_ <br /> r/ <br /> • Property Lines � I�dicate North <br /> • Outline antl dimensions ot all existing and � Show any proposed ��ading changes � <br /> proposed struclures on the lot � Show measurements <br /> • Czisling and proposed ulilities O <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS hone 259•8815. � <br /> �, qll calls lor inspedion shall be made 24 hrs in advance-p Z <br /> 2. All work shall be performed in accordance with lhis permit and wrrent City of Lvure!!Design and::onsiruclion � Q <br /> Standards and Speciticatiors. <br /> 3. Call Locetion Underground Servi.- �B hrs.before you dig.TOLL FREE NUMBER 1-800•424•55 . � <br /> O <br /> � � � <br /> N H . <br /> rn ^ <br /> o � L <br /> a y ` <br /> [ <br /> C�7 4~ <br /> � � <br /> pCKNOWLEDGEMENT OF(ONDITIONS � ;` <br /> The�mdersignea owner/applicant hereby agrees lo hold anA save harm- � �,� <br /> i, __ (he Ciry ol Everetl Irom any and all claims tor damages, costs. O ` <br /> expenses, or causes oi action ihal may arisa because if installation � r <br /> / / �� _ and mainienance of the impwvement or other rigM�d-v.:.Y use hereto F. <br /> �% ����F applied lor and lurlher agrees to remove same upon notice irom the <br /> Date City and to replace public properry damaged �hereby. � �,, <br /> pproved��l[Gon Irudion / � <br /> � `� <-, <- � �' � y -��_s-Y �: <br /> 1� s • ��'' � 7 � � i N'' <br /> : ( �'.'/- — �— � Date � <br /> � Dale <br /> FINAL INSPECTION Signature ol Applicant '�y ; <br /> Fpproved asConstruct d,_ y�pRK AU7HORIZED BY THIS PERtdIT MUST BE STARTED WITHIN ' <br /> everett PUl7LIC\VOFKS DFPAR7MENT <br /> 1B0 DAYS OF DATE PE}7MIT IS ISSUC-1 AND THEREAFTER IS TO � _ <br /> 3200 Cedar Slreet BE DILIGENTLY PUR�'iED TO COMPIETION. THIS PERMIT MAY BE : <br /> � Everelt.'JJA 98201 CANCELLED BY TH[ .;ITY UPON AN\'STOPPAGE OF WORK ON THIS � <br /> Phane:259-8875 PROJECT OVC-R 90 JAYS DURATION. <br />