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Appliwlion Far � / <br /> � PUBLIC WORKS PERMIT Date �z��s�9, <br /> �, ,�„ �4 <br /> .� PUBLIC WORKS DEFARTMENT Public Works Permit N �7 3 � <br /> 3200 Cedar Sireet <br /> Everett,WA 98201 259•8810 guilding Permit M 57435 <br /> T� POSTING �9� <br /> IYPE OR PRINT ONLY ' Q(p Public Warks Fee$ � <br /> D P FINLEY CONTRACTOR 8405 54TH AVE W MUKILTEO 98275 425-743-4000 <br /> Owner MailingAddress City Zip �hone <br /> OWNCR <br /> Applicant Mailing Address Gty 2ip Phone <br /> Describe Proposed Work NEW NOUSE � <br /> 1� <br /> � <br /> PROJECT ADDRESS(if known) �CQ�l ( � ,,����� LOT 1 SNORT PLAT 9-97 � <br /> Attach four(4)copies ol plans lor proposed work-Draw to sca!e and note the following if appiicable: � <br /> •Property Lines •Outline and dimensions of all existing antl�iop�c�structures on the lol •Existing and proposed utilities O <br /> •Centarline ol stree� •Indicate North •Show any proposad grading changes •Show ineasuremenis � <br /> DO NOT WRITE BELOW THIS LINE <br /> PFRMIT CONDITIONS: � <br /> 1. All calls for inspection shall be made 24 hours in advance-phcne 259-8810. O <br /> 2.AII work shall be performed in accordance with this permit and current City of Everett Design and <br /> Construction Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUNiBER 1-800-424-5555. � <br /> � 01-15-98 i:2�Ft1 � <br /> N 57435 O <br /> EUIL� 685.94 <br /> 'r'LUI'fE 84.00 � <br /> MECH 60.00 <br /> SRCHG 4.50 <br /> DRII�E 20.00 <br /> N 9623 <br /> !JATEF 650.00 <br /> If 313(30 <br /> SEWFF 70.00 <br /> UTILITY 1296.00 <br /> r� it 57640 <br /> /�� � 'cLF.0 35.00 <br /> hll�� TOTAL �905.44 <br /> \ ��,� �t3�4�� i�ii��: 2905.44 <br /> ACKNOWLEDGEMtN�"OF[.'ONDITIONS <br /> �/.���C, //: _ �/��/� The undersigned ownedapplicant hereby agrees to hold and save hartnless <br /> ( L j� ��Q, � L �7 Ihe Ciry of Everett from any and all claims lor damages,costs,expenses,or <br /> Approved for G�stryctio�'•� p�1e causes oi action that may anse because of installation and maintenance of <br /> , the impmvement or olher nght-ol-way use hereto applied for and futlher agrees <br /> ✓ :�' . �- to remove same upon notice from t Ciry and to repace public property <br /> �,/� /y �. ��f� damaged ih <br /> FIN�1SA�C 10 Date <br /> Approved as Constmcted <br /> Sig ture of plicant Date <br /> INORK AUTHORIZED BY THIS PEfiMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PEfllv f ISSUED THEREAFfER IS TO BE DILIGEN7LY PURSUED TO <br /> COMPLETION.THIS PERMIT MAY OE CANCELLED BY THE CIN UPON ANY STOPPAGE JF WORK ON iHIS PROJECT OVER 90 DAYS DURATION. <br />