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Date 2�19/86 <br />Application For <br />PUBLIC WORKS PERM17 <br />Print or Type Only <br />Pu�i1c Worka Permit • �'�'" _�� <br />Biap. oeo�� • 86/16066 <br />Puolic WorMa Fea <br />Totel ree S <br />Leaa Aoo� Fee Paia S_�_ <br />BnlanceDoa �. �Q'� <br />Metco Constructior. Co. 17018 15th Avenue N.E. Seattle 98155 363-0316 <br />Owner Mailing Address City 2iD Phone <br />Same <br />Applicent Mailing qddress <br />Describe Proposed Work <br />Project Address (if known) <br />Construct Single Family Residence <br />rh <br />Lor <br />Atlach four �4) copies of plans lor proposed work • Draw ic scale end not^ Ihe following as applicab'e: <br />• Property Lines • Centerline ol street <br />• Outline and dimensions ot all exist�ny and • Indicale Nor�h <br />pr�posed structures on ihe lot • Show any proposed grading changes <br />•[xisting and proposed utilities • Show measuremenis <br />Phone <br />PEr7MIT CONDITIONS <br />t. All calls for inspection shall be made 24 hrs. in ativance - phone 259•881 5. <br />2. All work shall be performed in accordance with Ihis permit and current City ot Everett Design and Conslr�ction <br />Standartls and Specificalions <br />3. Goli Location Underground Service 48 hrs. 6efo�e you dig. TOLL FREE NUMBER 1•800•424-5555. <br />7� ��Z. V/ �M'IUl a✓K. -G�h JT� �.GC�L9Yi �ry�/W3� � � 'f' �LG[��l <br />S. S'-�('e �,.o..C/2 c<,�,lt- � / / � <br />��- -��.- �- -�.�-t` 1�,�.. <br />� . G-�.-�e, .Cu� �- � .��.�r .�- �,�..� .�z,.,..�.:�. <br />��. <br />c� � ` <br />p s��• <br />FINALINSPECTION iC <br />Approved as Constructed L� <br />everett PUBLIC WGRKS UEPARTMENT <br />� 3200 Cedar Street <br />Everetl, N'A 98201 <br />Phone� 259-8A15 <br />o.l <br />W <br />� <br />� <br />� <br />�J <br />ACKNCWLED ,EMENT OF CJNDITIONS <br />The undersigned ewr,er/applicant hereby agrees to hold and save harm- <br />less the City o( Ev�rett trom any and all claims for damac�es, cosis, <br />expenses, or causc�� of action ihat may arise he.cause of installa6on <br />and maintenance of Ihe improvemenl or other ricM•ol-way u�e hereto <br />applied �or and further agrees lo remove same apon notice Irom ihe <br />City and to repl e public property damaged ihereby. <br />� � <br />Si nature ot A"licant �ate <br />WORK �UTI"�RIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS �)F DAT: PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PIiRSUED TJ COMPLETICN. TNIS PERMIT MAY BE <br />C�NCELLED BY T.YF CITY UPON ANY STOPFAGE OF l4�ORK ON THIS <br />PROJECT OVFR f-0 DAYS DURATION. <br />