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/ <br />2/5/93 Public WoiW Permit ��LJ�Q{ <br />e � _ <br />Date Application For TO wifING -7 ?3 Bldg, Debt. e 39476 <br />PUBLIC WORKS PERMIT P°°To: FeeFee s <br />Less APPL Fee Paid $ <br />i <br />Balance Due S <br />Print or Type Only <br />Visscher Builders 4706 W View Dr Everett RMA 98203 252-3377 or 259-1660 <br />Owner Mailing Address City Zip Phone <br />Same <br />Applicant Mailing Address City Zip Phone <br />Describe Proposed Work <br />Project Address (if known) <br />Lot 28, View Acres Div 2 <br />Attach for ( ) 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 />• 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 hrs. in advance - phone 259.8810. <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and Construction <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1.800-424.5555. <br />4. f,qx jl,;vG.vay -Fretm Fr0f ' -( I i,1G +e 6c�c C4 Vc-nnot, r,t rO\\, <br />Approved for Coonnstructio I Date <br />FINAL INSPE TION Date <br />Approved as Constructed <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />Phone: 259.8810 <br />ACKNOWLEDGEMENT OF CONDITIGrIS <br />U/ <br />M <br />O <br />n <br />z <br />O <br />Ch <br />a <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the City of Everett Irom 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 re lace public property damaged thereby. <br />ig ture 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 />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />