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m <br />n <br />Date 12-13-93 <br />Applicatio � or <br />PUBLIC WOR�S <br />d <br />Print or Type Only � <br />.Ni i <br />Andy Zuanich 5410 S 11lt.Ai <br />Ownei <br />Applicai�t <br />Descrihe Proposed YJork <br />Project Address (if known) <br />6 -5-28-5 <br />TO POSTING_ f �� � <br />PERMIT <br />8 O O O 1� O C 7 O Op N.p <br />! I� M� M N M � M� G O <br />� � ai YI <br />,o <br />Everet WA 90 3 52-3711 <br />�S�m'm ` $ .�".Cs 11I <br />Mailing Address <br />new house <br />Zip <br />Atlach four (4� copies of plans for proposed work • Draw to s�ale and note the following ae applicable: <br />• Property Lines <br />• Outline and dimensions ot all existing and <br />proposed structures on the lot <br />• Ezisting and proposed utilities <br />/ <br />P�Ellc WorAe Permlt � _t <br />B�Ep. Dapt � <br />Pubiic Works Fee <br />Tolal Fee S <br />Lesa AD01 Fee PeiE S <br />Balance Due s � <br />• Cenlerline of sireet <br />• Indicate North <br />• Show any proposed grading chandes <br />• Show n•�easwements <br />Phone <br />PERMIT CONDITIONS <br />1. Ail calls for inspection shell be made 24 hrs. In advance • phone 259-8810. <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and Construction <br />Standards end Specifications. <br />3. Call Locetion Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800-4245555. <br />�• ��vL dri�e��J -�ra+r� �ro�e+'� 11�e � �dc� o-F,�aveme*rb in (L,O,w. <br />�,,�1_�1 �.� ��Z�93 <br />A�ved or �o struction Date <br />(� C / <br />?�l �'�"t—�— / - � J -�l <br />-Pf�JAL INSPECTION Date <br />Approved as Constructed <br />PUBLIC 1VORK5 DEPARTM[NT <br />3200 Cadar Street <br />Everett, WA 98207 <br />Phone:259-B?10 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />� <br />� <br />� <br />� <br />� <br />O <br />a <br />The undersigned ovneqapplicant hereby agrees to hold and save harm• <br />less the City ef ���erett irom any and all claims for damages, costs, <br />ezpenses. or c� ; of action that may arise because of installation <br />and maintenar � the improvement or other right�of�way use hereto <br />app:ied lor an �� er agrees to remove same upon notice Irom the <br />Cily and ;o re; public properry damaged thereby. <br />/ <br />Signature ol " li Date <br />WORK AUTf10Rl_ Y THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERAIIT IS ISSUED AND TIIEREAFTER IS TC� <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAV 8E <br />CA!JCELLED BY THE CITY UPON ANV STO�PAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />