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�{a PQSTING AUG �---i�_ <br /> �e�}y'� APPbcaban <br /> ,� PUBLIC WORKS PERMIT Date 1-4-96 � <br /> .� <br /> � PUBLIC WORKS DEPAR7MENT Public Works Ae•mit N ��/� �S <br /> 320D Cetlar Street -- — <br /> Everett,WA 98201 259-8810 50485 <br /> Buildinq Pemit q <br /> IYPE OR PRINT ONLY � <br /> Public Works Fee 5 �� <br /> Autumr. Pevelc�ment 2607 147th P1 SE P1111 Creek 98012 742-1166 Larry Jones <br /> Owm�r ldailing Address Cit <br /> Y Z�F Phor�o <br /> Owner <br /> Applicant MailingAddress City Zip Phone <br /> Describe Proposed Work new house <br /> W <br /> H <br /> - <br /> PROJECT ADDRESS(if known) �216 Upper Ridge Rd Lot 3 SP 111202-19-95 � <br /> Atlach four(4)copies of plans lor pmposed work-Draw to scale and note ihe followinq if applicable: W <br /> •Property Lines 'Outline and dimensions of all existing and proposed structures on ihe I�t •Existing and proposed utilities O <br /> •Ceriterline of street •Indicate North •Show any proposed grading changes •Show measurements <br /> DO 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 performed in accordance with this permit and current City of Everett Design and O <br /> Construction Standards and Specifications. <br /> 3. Call Location Under�round Service 48 hrs, before you dig. TOLL FREE NUMBER 1-800-424-5555. � <br /> V♦ <br /> O <br /> .,-;,:;�_ , ,,,�..� ,��.,u,,� a <br /> ; <br /> y000soass <br /> °LUu Q74�,5!"� <br /> FLEG l98.�'.: <br /> �fECH 36C'.J_' <br /> �CHRG gc.s • <br /> �'t IVWV 4�l.:C <br /> °LN CH 42Z,"' <br /> `::'27?04E0 <br /> O�� -,cFir� /'�-�� <br /> ��(/.. <br /> �. �u„.�,� s ,g6 _ <br /> ACKNOWLEDG�EFIE'NT OF�'iONDITI�NS <br /> ' /J vr/1�/l / /� �� The undersigned owr.edapplicant hereby agrees to hold and save hartnless <br /> (��L'_���� IC..B�� the City ot Everett Irom any antl all claims for damages,costs,exp�:nses,or <br /> Approvetl for Con ruction Date causes of action that may arise because of installation and maintenance of <br /> � /� theimprovementorotherright-of-wayuseheretoappliedforandfurtheragrees <br /> � _ '� to remove sam upon notic the City and In replace public propeAy <br /> �1�- -�—�— �-.1y�_y damaged ther <br /> nrv�.�uJSPECT10N Date <br /> Approved as Constructed <br /> � �t/C <br /> 7 <br /> ( Sig re ol pli Date <br /> WORK AUTHORIZED BY THIS PERMIT PAUST�E STARTED WITHIN;d�DAYS OF�DAT PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLFTION.THIS PERMiT MAY BE CANCELL[D BY Tf{E CIN UPON nNY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAY.S DURATION. <br />