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I ' <br /> Appl�tian For � ��— �� '/ <br /> � PUBLIC WORKS PERMIT Date 9-10-96 <br /> �DD UBLIC WOR�DEPARTMEN� �� <br /> ry n 2 6 Z� 1'ublic Nbrks Pertnit M _�_ <br /> TO POSTING 32°°`�a'S'�, <br /> everett,wqs i 25s-eeio 52815 <br /> Building Permit!t <br /> a � g g � � � S g ��lic Works Fee$��~ <br /> TYPE OR PRINT ONLY N � o � « � r�, t� � � � <br /> Leon Franssen 1702 WashiTfgtc'�'Ave Mukil��te� 9 75 '"�5-5220 <br /> Owner Mailing qddmss o,� � � �� �ZiP Phene <br /> _ Owner � � a� � � � � 2 � � � � tnt5 <br /> Applicant Mailing Atldress City Zip Phone <br /> Describe Proposed Work new house <br /> � <br /> � <br /> PROJECT ADDRESS(if known) .7�� Vj'j��� rl�+�c.. 1 y}� 2� I�j��—� � <br /> Attach four(4)copies ol plans to�proposed work•Draw to scale and note the fellowing it applicable: O i <br /> •Property Lines 'Outline and dimensions of all existing and proposed structures on the lot •Existing and proposed utilities <br /> •Centerline ol street •Indicate Nortli •Show any proposed grading changes •Show measurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS: � <br /> 1. h!I calls for inspection shall be made 24 hours in advance- phone 259-8810. O <br /> 2.All wor!:shall be performed in accordance with this permit and current City of Everett Design and <br /> Construction Standards and Specifir,ations. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-4245555. � <br /> �. Con�f- �af dr�F�f -�C s�,r, al�� �r/�-► � <br /> ,1� rrp(� �-- a i <br /> �l ��•� ) � c"(.v`P` / <br /> (.t�j%1��°G� ,E'�i dui.� <br /> � � H ���e�-/ SI c-�� ��_y0 � <br /> r10 /v.� S �(��`O n C�7�/r`� �'- <br /> u�d-5� <br /> l,( !i!��a J <br /> v�"� <br /> ,� (,�',jNae ��� � � �o S�����o;, C�,GP�' <br /> ACKNOWLF.DGEMENT OF CONDITIONS <br /> PL/� n��^//� Q����� The undersigned ownedapplicant hereby agrees to hold and save hartnless <br /> �,`�j 7�.�=� ihe City of Everett from any and all claims tor demages,cosis,ezpenses,or <br /> A�prdved for Construcllon p��e�r causes of achon that may arise because of Installation and maintenance of <br /> thoimpinvmn nghb�f-wayuseheretovppliedlorandturtheragrees <br /> to remove sa upon n tice fr,;m the Clty and to replace public property <br /> damaged t ERb . <br /> FINAL INSPECTION Date % <br /> Approved as Constn;cted � <br /> / � G 5 � <br /> Slgriature of Applicant Date <br /> �VORR AUTHORRED B"THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DAfE PERMIT IS ISSUED AND THEREAFfER IS'f0 BE DIIJGENTLY PURSUED TO <br /> COMPLETION.THIS PERMIi MAY BE CANCELLED BY THE CI7Y UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURAil04. <br />