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� Applicatlon Fa � . . . � 1-4-96 / <br /> � PUBLIC WORKS PERMIT Date <br /> PUBLIC WORKS DEPARTMENT Public Works Permit a Q lP I O�¢ <br /> 3200 Cedar Stmet <br /> Everett,WA 98201 259-BB70 AUG 2 9 �gg�uilding Pertnit M 50484 <br /> NPE OR PRINT ONLY ?� PO ST i N G Public Works Fee S � <br /> Autumn Develonmen[ 2607 147th P1 SIi Mill Creek 98012 742-1166 Larry Jones <br /> Owner Malling Address City Zip Phone <br /> Owner <br /> Appiicant Malling Address City Zip Phone <br /> Describe �roposed Work new house <br /> W <br /> H <br /> - <br /> PROJECTADDRESS(ifknown) 7212 Upper Ridge Rd Lot 2 SP If1202-19-95 � <br /> Atlach four(4)copies ol plans lor proposed work-Draw to scale and note the following if applicable: � <br /> •Property Lines 'Outline and dimensions of all existing and proposed structures on the lot •Existing and proposed utilities O <br /> 'Centerline of street •Indicate Nonh •Show any proposetl grading chenges 5how measurements <br /> DC� NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS: � <br /> 1.All calls for inspection shall be made 24 hours in advance-phone 259-8810. <br /> 2.All work shall be pertormed in accordance with this permit and current City of Everett Design and O <br /> Construction Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs, before you dig. TOLL FREE NUMBER 1-800-424-5555. � <br /> �/ <br /> O <br /> a <br /> o.;i:4��s �o:.;sar ,�,�,s,-,,,u � _:�.: <br /> , <br /> a000so4�4 <br /> �oc s�.-�.u, <br /> �-�u 'b84,'3D <br /> `4ECH bb0:JQ <br /> �cH�r �4 s.o <br /> ACKNOWLEDl9E'�NT OF QONp1�ON5 <br /> MC ///�/�� The undersigned owner/applic�n�he�epy agrp�sapjiold and save harmless <br /> ��� ihe City of EvereH from any antl'aI�I ciaims(or damages,costs,expenses,or <br /> Approved for nSiruction causes o(action ihat ma ari <br /> Data Y �e'i�e oT installalion and maintenance ot <br /> the improvement or other ngly����sa hereto�1§tl for and luither agrees <br /> 'o remove sam upon notice C�arM,,to`re lace uNk ro <br /> � �� . _ _ G_� � " damagedth y. -. -. P P P PeNY <br /> FINALINSPEC710N C�F��� ��175.:' <br /> Date <br /> AF .roved as Constructed <br /> S� ��'a ,�P�, ' 3/�5� <br /> Date <br /> WORK AUTHORIZED BY 7HIS PERMIT MUST BE STARTED WITHIN 180 DAYS 0 PERMR IS ISSU AND THEREAFfEp�S TO BE DILIGENTtv F'URSUED TO <br /> COMPLETION.THIS PERMIT MAy BE CANCELLED BY 7HE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT QVER 90 D.4YS DURATION. <br />