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qppliu�tion For � <br /> � PUBLIC WORKS PERMIT �a�z �'19-96 <br /> PUBLIC WORKS DEPARTMENT Public Works Permit M �6/�.7� <br /> 3200 Cedar Sireet <br /> Everett.WA 98201 259-B810 Building Permit# 52339 <br /> CT {,� SEP 1 7 1991 / <br /> TYPE OR PRINT ONLY �� {�Q,31�!M G �� — Public Works Fee$� <br /> Grigory Gusakov 10411 3rd Ave SE Everett 98208 347-0716 <br /> Owner Mailing Address City Zip Phone <br /> Owner <br /> Applicant Mailing Address City Zip Phone <br /> Describe Proposed Worlc_ new house � <br /> — — � <br /> /�� <br /> — V♦ <br /> PROJECT ADDRESS(if known) 10407 3rd Ave SE Lot 3 SP lf 18-94 � <br /> Attach four(4�copies of plans for proposed work-Oraw to scale and note the tollowing n�,�plicable: O <br /> •Property Lines `Outline and tlimensions of all existing and proposed stvctures on ihe lot •Existing and proposed utilities <br /> •Centerline of sireet •Ind�^.ate North •Show any proposed grading clianges •Show measurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS: Z <br /> 1.All calls for inspection shall be made 24 hours in advance- phone 259-8810. O <br /> 2.All work shall be performed in accordance with this permit and current City of Everett Design and <br /> , Construction Standards and Specifications. <br /> • ' 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � <br /> i <br /> �� � P1�1,/�st✓y-F � inS�<���n 7�I.e w2��Sfr✓ic� �-(�it� O <br /> �'�'.t/I�. <br /> s �� sp�-�Yr �(r.�'' �r �IFP�4 /'3p ,��sf � ;�r���� a <br /> �� �o��. <br /> 08/07/96 1=30P� Ch70��,, >, " � : <br /> / <br /> NOQ05�::9 <br /> 3LDG tS?5.50 <br /> PLEG 496.O1 <br /> HECN �80.00 <br /> SRCHSG 44.5� <br /> OSIVW;' �^D.CN1 <br /> ��f , L 4 g,� �q-. <br /> � ACKNOWLEqG�QF CONOITIONS <br /> � � The undersigned owner/applic�HE� y'agrees to hold and save hannless <br /> the City of Everett Irom any anS��`L`laims fofd�n3�s,costs.expenses,or <br /> Approve for Consiruction Da causes of action that may aris�.��ise Qf�il�9f811aj�qn and maintenance of <br /> theimprovementorotherright-�+icw�ay�ehe�efo p�edforandiurtheragrees <br /> � � %/ ' to remove same upon notice�r�o'ul..l�e Ci�y_a �o{eplace public property <br /> .dv Q_S'�� damaged thereby. tt l ,-;�s.?, <br /> 7L1, v <br /> FINAL INSPECTION Date /� <br /> Approved as Constructed / ///j� �/� �iw /G� � ', �Gj <br /> �/ G�G�f C.Pc/ /LO v <br /> Signalure of Applicant Dale <br /> WORK AUTHOFI2ED BY 7HIS PERMIT MUST BE STARTED WITHIN 100 DAYS OF DATE PERMIT IS ISSUED AND I[REAFfER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLEfION.THIS PERMIT MAY BE C�NCELLED BY THE CIN UPON ANY STOPPAGE OF WORK ON THIS PR.)J._CT OVER 90 DAYS DURATION. <br />