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Date 10-01-91 <br />APPIicatiol� ror <br />PUBLIC WORKS PERMIT <br />Print or Type Onl/ <br />Whi twill <br />Puget Sound Design <br />4825 4I- View Dr <br />4208 Russel Rd <br />Describe Proposed Work sunroom addn; 70 'SF <br />Everett 98203 <br />Nukilteo 98275 <br />Pub"' <br />WOYeS Pmm't <br />aide Dsot. • 91/27853 <br />Pubt2 Works Fee S <br />Total Fee <br />Less apol. Fee Paid $ <br />Balance Due S <br />252-1084 <br />Zip Phone <br />743-1611 <br />Zip Phone <br />Project Address (if known) 4625 t9. View Dr <br />Attach four (4) copies of plans for proposed work - Draw to scale and note Centerline of as apeelt able: <br />• Property Lines Indicate North <br />• Outline and dimensions of all existing and • Show any proposed grading changes <br />proposed structures on the lot • Show measurements <br />• Existing and proposed utilities <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, Cell Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1.800-424.55 . <br />P"J &{ w is %S <br />for Construction <br />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 />! 7 <br />/D - 7 9 <br />or <br />z <br />C <br />■ <br />C <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <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 />Dale <br />Signature of Applicant <br />WORK RMIT MUST BE STARTED <br />B0 DAYSOFAUTHORIZED <br />PERMIT ISEISSUED AND THEREAFTER ISHIN 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 />