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.. _ . _. -- — __.. <br /> -- -- — ' - �:`�. <br /> ., <br /> � �Plication For ,'� <br /> PUBLIC WORKS PEHMIT �a�B 7-21-98 "' <br /> PUBLIC WORKS DEPARTMENT Public Works Permit M `�1 <br /> 3200 Cecfar Street ia� <br /> Everett,\YA 98201 255-8870 <br /> • Builtling Pertnit M___ 59552 __ <br /> 7YPE OR PRINT ONLY i���D�� Public Works Fee� /.3� r . - <br /> ���I � CJ 'l � J l .� C) l <br /> Qj � ,e : .� � :> > � <br /> r <br /> ,.1 T I � O '�,�� [ . ..) �. ^ ti t, r —+ .J <br /> � � v ,r. <br /> Owner MailingAddress �'� City �2ip •..� •�' Phone g� _ <br /> E(Z-=C.- �9'QU�XiLf� N�.S-3"�5-�I°i-IS( i�: `.a r .i ` <br /> �ey-4'27-2'4�OD'I2 � _ , _ ;: :r: � <br /> � � - : «: <br /> Applicant MailingAddress � �� � Cjly� � r _� �ZiP ..;� i-+ . ,=Prone �. - <br /> '),-a�o ' c�[� . .. , n �. .� z '- .. .n . _ .1 .c _ . <br /> Describe Proposed Work new 14 unit apt � <br /> _�Gr s.Sana�� ' -f /z02— /3 -8S �on c✓r5 ' s � <br /> � <br /> PROJECT ADDRESS(if known) 30- 3h d SE, � <br /> Atlach four(4)copies of plans for proposed work-Draw to scale and note ihe following if applicable: � <br /> •Property Lines •Outline and dimensions ol all exlsting and proposed stnictures on the lot •Existlng and proposed utllNies O <br /> •Centerline ot street •Indicate North •Show any proposed grading changes •Show measurements � <br /> �. DO NOT WRITE BELOW THIS LINE <br /> PER ONDITIONS: � <br /> 1.All calls fo ' spc•ction shall be made 24 hours in advance-phone 259-8810. O <br /> 2. All work shall h erformed in accordance with this permit and current City of Everett Design and <br /> Construction Stan ards and Specitications. <br /> 3. Call Location Underground Service 48 hrs.be!ore you.dig, TOLL FREE NUMBER 1-800-424-5555. � <br /> 7, Lc�O�^� z� 6e �r,c ftz.H Civ�C �O�Lav� v+ <br /> Q�Q�/ro�/C o� Oh �_.�e8 'f',9 �'��y 4�.�rhe� � <br /> S(✓�� . <br /> ,� s � , q51S ��s�ius' G -�s-�q -- TO POSTING Nov u s w�� <br /> zls n� �t9�G „Ular ��( � -�s4q �J <br /> 3)c��� ci� re�w, Fn�ke�/� C�a�� nl �acl�ase — ��e��c� f �or� <br /> C��� s,3 �u�l o�-� s�s�o� o�'�F Yef - .r, �e �Ssae-s J <br /> �)�J}6'pau.�� s�f�. �(c,1 <br /> F� �r �c �� f P�2 I'�� rt5 ��u�.r �' CG cf[ �Otif/��cQ� <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicanl her^by agrees to hold and save harmlcss <br /> ' Zg' 9 B the City of Everett from any and all cla ns for damages,costs,expenses,or <br /> causes of action that may anse becau�e ot installation and maintenance of <br /> p rove o onsin} ion Date theimprovementorother�ght-ot-wayuseheretoapplietl}orandturtheregrees <br /> � to remove same upon notice irom tha City and to repiaca public property <br /> damaged there6y. <br /> FINAL INSPECTION Dite <br /> Approved as Cons;ructed -----� <br /> Signatureoi7lp icant Da <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 780 DAYS OF DATE PERMIT IS ISSUED AN�THEREAFTE�i IS TO BE DILIGENTLY WRSUED TO <br /> ".._.__.. ,......�....._...,...�,,..�..��,�.......,,�,.,.�.��..n.�n.�v crnoonr_c nc�unov n�i tuic opn icnr M�F <br />