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Date 9-29-91 :,,,,. � r,-. :wo�k.a�,mu. _ <br /> ' a�a� o.o�.. 91/27774 <br /> Application ror <br /> PUBLIC WORKS PERMIT P��To�pMFee s <br /> Le�s ADO�Fee Paitl s <br /> Babnce Due S <br /> Print or Type Only <br /> D.E. C000er 2G24 Viewcrest Ave Everett 9A203 349-0562 <br /> Owner Mailing Address City 2ip Phone <br /> Northern Pacific Const 5409 85th P1 NE Marysville 99270 659-0636 (Dave or Mary) <br /> Applicant Meiling Address City Zip Phone <br /> Describe Proposed Work Cover over existinq oatio <br /> ; LL <br /> '�� ! ProiectAddress(ilknown) 2624 Viewcrest Ave � <br /> ��� I Attech four(4)copies of plans for proposed worA• Draw to scale and note the following as applicable: � <br /> _`�, � • Property Lines • Centerline of slreet � <br /> • Outline and dimensions of all existing and • Indicate North � <br /> - i proposed structures on the lot • Show any proposed grading changes <br /> • Existing and proposed utilities • Show measurements � <br /> DO NOT WRITE BELOW THIS LINE � <br /> I PERMITCONDITIONS <br /> � 1.All cevs�nr Inspection shall be mede<^4 hrs.in advance•phone 259-8810. � <br /> 2.All wc rk s, "be peAormed in accordance with this permit and current City of C-verett Design and Construction r <br /> Standerds end Specifications. <br /> 3.Call Locat;on Underground Service 48 hrs.before you dlg.TOLL FREE NUMBER 1•800•424•5555. � <br /> C <br /> ;� ;. , -- �:. �<< : � � <br /> � � �/r�, <� ;� ;- . , � . _ � <br /> • ,�;,> <br /> il. �� � <br /> - � �S <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owneyapplicant hereby agrees to hold and save harm <br /> ' less the City of Everetl irom any and all claims for damages, cosis <br /> ezpenses, or causes of ac�ion that may arise because ol installatior <br /> and maiMenance ol the improvement or other right-ol•way use herele <br /> applied for and lurlher agrees to remove same upon nolice Irom ih� <br /> Approved for Consiruction Date City and lo replace public property damaged Ihereby. <br /> FINAI INSPECTION �a�e Date <br /> Approved as Constructed Signature ol ApPlicant <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE START�D WITHII. <br /> �Ar� PUBLIC WORKS DEP.IPTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TC <br /> 3200 Ceder Stree� BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Everet4 WA 98301 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK OP!THI: <br /> Phone:259�8810 PROJECT OVER 90 DAYS DURATION. <br />