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'�� - i`� - z` � � . �:,� �.�-� <br /> Date 2-3-9z Pul�m Wo�As Perm�1• _!_�: <br /> eiee Deo�-• 92�3'i493' <br /> Applicalion For <br /> PUBLIC WORKS F'ERMIT �uOTo�FAeFve s <br /> �,. <br /> Lesa Pppl Fex Peia S — <br /> J (i — <br /> r� _.� �„ Baienca0ue S <br /> i [ <br /> Print or Type Onry • '" ` ' <br /> Trosvi8 Robert 1620 Silver Lake�Rd '�'r Everet[ 98208 355-4053 or 259-3505 <br /> Owner MaiNnp Atld�ess . ,.� .. . C�SY,.. _-. ZiP Phone <br /> ',i �i-� r i I,i � ' <br /> rr. � ��.r C� ' r 1. t�l <br /> I � ��I 1�1 �:. . � .r r <br /> ONQOil I :.^. �..� . • . :� r�� � � _ -•. . . <br /> Applicent Mailing Address City 2ip Phone <br /> Describe Proposed Work foundation under house to be moved 6 new garage _ __ <br /> W <br /> �i � �. -� _�� a�.,c-- s� �. <br /> prolect Address(if known) . <br /> Attach four(4)copies of plans for proposed work• Draw to scale and note the following as applicable: � <br /> • Property Lines • Cenlerline of street � <br /> • Outline and dimensions of all ezisting and • Indicate Norih <br /> proposed siructures on the lot r Show any proposed grading chan�,es <br /> • ExistinB rind proposed utilities • Show measurements M <br /> W <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1.All cells for inspectlon shall be made 24 hrs.in advance•phone 259-8810. � <br /> 2.All work ahell be peAormed in accordence with this permit and current City of Everett Design and Construction <br /> Standerda and Specifica!ions. <br /> 3.Call Location U�derground Service 48 hrs.before you dig.TOLL FREE NUMBER 1•800�424•5555. � <br /> ����! J-:�� O <br /> � <br /> � <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> � , � 1 ne undersigned owner/applicant hereby agrees lo hold and save harm- <br /> less the City ol Everet� trom any and al� claims for eamages, costs, <br /> expenses, or causes ol action that may arise because of installation <br /> ----�� i, ,� ' <�l.�s� 7_ I�I_. )� aod mainlenance of the improvement or other right�of•way �se hereto <br /> y� L applied lor and further agrees to remove same upon notice from the <br /> qppr v�Consiruction ��1e Ciry and to replace public property damaged ihereby. <br /> A� �� T O � Dat� Date <br /> Approved as Conslructed Signalure ot Applicant <br /> WORK AUTHORIZED 8Y THIS PERMIT MUST BE STARTED WITHIN <br /> �� PUBLICWORKSDEPARTMENT 1B0 DAYS OF DATE PEFMIT IS ISSUEC AND THEREAFiER IS TO <br /> 3200CedarStreet BE DII�GENTLY PURSUED TO COMPLEI'ION. THIS PENMIT MAY BE <br /> Everetl,WA 98201 CNNCELLED 9Y THE CITY UPON HNY STOPPAGE OF WORK('N THIS <br /> Phone:259•8870 PROJECT OVER 90 DAYS DURATION. � <br />