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Date ` rW\ I VuEtic Worka Parmil • <br />Application For <br />PUBLIC WORKS PERMIT <br />Print of Type Only Plan check No: H 45730 sEPA <br />Appllcat.Date: 10/03/94 <br />Job Addreee: Slb3 S 4TH AVE <br />Owner: HAMMER REIDER <br />Tenant: <br />— Proposed Use: SINGLE FAM?T,Y RESIDENCE <br />Owner Deac. of Work: <br />HOUSE ADDN <br />Applicant <br />Describe Proposed Work _ <br />Prolect Address (il known) <br />eiao. o.oi. • _ <br />Public Worka Fee s <br />ialel Fae <br />lefa Ropl Fae Pe10 s <br />e�iance ��e S <br />Phone <br />OFFICE SET JOB SET :ip Phone <br />APPROVED FOR PERMIT: DATE_/_/_ BY <br />Attach tour (4) copies ol plans for proposed work • Draw to scale and note the tollowing as applicable: <br />• Property Lines <br />• Outl!ne and dimensions of all existing and <br />proposed structures on the lot <br />• Existing and proposed utilities <br />• Centerline of street <br />• Indicate North <br />• Show any proposed grading changes <br />• Show measurements <br />PERMIT CONDITIONS <br />1. All cells for inspectbn shell be made 24 hrs. in advance • phone 259•881 O. <br />2. All work shali be performed in accordance with this permit and current City of Everetl Design and Constructlon <br />Scandards end Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800•424•5555. <br />PUBLIC WORKS PERMIT <br />NOT REOUIRE� <br />zv� � <br />DATE �� '` y'` <br />Approved tor Consiruction Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />ACKNOWLEDGEMENT OF COND�TIONS <br />W <br />H <br />w <br />� <br />� <br />O <br />� <br />� <br />O <br />a <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the Ciry ol Everel� irom any and a�l claims br damages, cos�s, <br />ezpenses, or causes ot aclion that may arise because of installation <br />and maintenance ol the improvement or other right-of-way use hereto <br />applied lor and lurther agrees to remove same upon notice Irom the <br />City and to replaCe Vublic property damaged there�y. <br />ol Applican� <br />Date <br />�AA�PUBLI: WORKS DEPARTI+tENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTcD WITHIN <br />3200CedarStreel �8� DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />� Everett, WA 98201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY 8E <br />CANCELLED BY THE CITY UPON ANY �TOPPAGE OF WORK ON THIS <br />Phone:259�8070 PROJECT OVER 90 DAYS DURATION. <br />