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H O H <br />�hr1� <br />D=x <br />C H <br />H Cr <br />HZ� <br />K o <br />H om0 <br />cH rV <br />xHygC <br />to O H d t=1 <br />OH <br />H <br />H <br />z <br />H H <br />gU <br />(�t7 rn <br />��hr1 <br />Z H V, <br />HOt/t <br />Vri <br />_j <br />all <br />ML� <br />Date - 'I <br />Applicafi.,•• Far <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Public Work$ Perm" e <br />Bldg. Depte 91/27777 <br />Public Works Fee S, <br />Total Fee <br />LHa APDt Fee Pald <br />Balance Due <br />Kathy Banks 1606 Virgina Ave Everett 98201 252-7121 <br />Owner Mailing Address City Zip Phone <br />Cascade's west 6845 60th Dr NE Marysville 98270 653-5064 <br />Applicant Mailing Address City Zip Phone <br />Describe Proposed Work new construction garagg <br />Project Address tit known) <br />inia Ave <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the following as applicable <br />• Property Lines <br />• Centerline of street <br />• Outline and dimensions of all existing and <br />is indicate North <br />proposed structures on the lot <br />• Show any proposed grading changes <br />• Existing and proposed utilities <br />• Show measurements <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 firs. in advance- phone 259.8810. <br />2. All work shall be performed in accordance with this pet mit and current City of Everett Design and Construction <br />Standards and Specifications. <br />3. Call Location Underground Service 48 his. before you dig. TOLL FREE NUMBER 1.800-424.5555. <br />Approved for Construction Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />Phone: 259-8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />Lit.[ <br />i <br />M <br />O <br />z <br />G <br />C^ <br />a, <br />The undersigned owner/applicant hereby agrees to hold and save harm. <br />less the City of Everett from any and all claims for damages, costs, <br />expenses, or causes of action that may arise because of installation <br />and maintenance of the improvement or other right-of-way use hereto <br />applied for and further agrees to remove same upon notice from the <br />City and to replace public property damaged thereby. <br />Signature of Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />^ANCELLEO BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />