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Date 5-30-90 <br />Appliwtion For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />t�i:ni�c �vmws r�r�m�i • . <br />�m� o�ni • 90/24731 __ <br />��,���,� wa,., «� � <br />iolal FRe <br />LesSl�pPl (Ce P.�¢1 5 <br />o.•i.,�« o��� a <br />Mark Sullivan 4306 S 3rd Ave Everett 98203 252-6589 <br />Owner 1.laihng Address City ..�n Phone <br />oomer <br />Mailinq Address <br />c��v z�p <br />Descrlbe Proposed Work 5�,..,g��e aa�,..rv„=ckyax-d��SFdt — <br />Proiect Address lil known) <br />Attach (our (4) copies of plans lor proposed work - Draw lo scale antl note the lullowing as applicable: <br />• Property Lines <br />• Outline and dimensions ol all exishng and <br />proposed structures on Ihe lot <br />• Existing and proposed utilities <br />• CeMerline of street <br />• Indicate North <br />• Show any proPOsed gradin9 chanye5 <br />• Show measuremenfs <br />LINE <br />PERMIT CONDITIONS <br />1. All calls lor inspection shall be made 24 hrs in advance - phone 259�88� 0. <br />2. All work shall be peAormed in accordance wlih this permit and current Ciry ol Everelt Design and Construction <br />Standards and Specilications. <br />3. Call Location Underground Service 48 hrs. belore you dig. TOLL FREE NUMBER 1•800•424-5555. <br />I V�\� -���! iC 1�-t�'l I^� ��� <br />� {` �`� � ��_ <br />ApproveA lor Construction Dale <br />FINAL INSPECTION Da1e <br />Appraved as Construded <br />everetl PUBLICWORKSCEPARTMENT <br />� 3200 Cedar Street <br />[vcrelt. WA 98201 <br />Phone: 259�BB10 <br />l�CKNO\'JLEDGEMENT OF CONDITIONS <br />W <br />� <br />�w <br />_ / <br />� <br />� <br />� <br />a <br />The unders�qned owner/apPlicant hereby agrees to hold and save hanm <br />less U�e City ol Cveretl Irom any and all claims for damac�es. co:;ts. <br />expenses. or causes of adion that may arise because ol installation <br />and maintenance ol ihe improvement or olher right�obway use herelo <br />applied ler and lurther agrees to remove same upon notice Irom the <br />City and to replace public properry damayed thereby. <br />Signature of Applicant Date <br />WORK AUTHORIZED �Y THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THFR[AFTER IS 70 <br />BE DIUGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANGELLED BV THE GTY UPON ANV STOPP/iG[ OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />