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Date <br />Applitation For <br />PUBLIC WORKS PERMIT <br />Pfint Of Type Only Plan Ch�ek No: B 4414d SEPA <br />Appllcat.Dates 04/19/94 <br />Job Addrese: 2172 WALNUT ST <br />Ownars COPfiLAND VALORY <br />Tenanta <br />Owner Propoead Ueo: SINGLB FAMILY RESIDfiNCfi <br />Daoc. of Works <br />FOUNDATION FOR fi%ISTING HOUSS <br />Applicent <br />Deecribe Propoaed Work <br />Project Addreas (it known) <br />PUC�ic Wark� Pa�mit • <br />BI6q. Oept. e _ <br />PuDLc Work� Fea <br />Tot�l Fea s <br />Leu �00� Fea P�iE S <br />B�I�nw Dae i <br />Phone <br />OFFICE SET JOB SST Zip Phone <br />t1PPAOVED FOR PSRMITs DAT6_/_/_ BY <br />Attech tour (4) copies of plens for proposed work - Draw to scale antl note tne following as applicable: <br />• ProDerty Lines <br />• Outllne end dimensions of all existing and <br />proposed structures on the lot <br />• Existing and proposed utilities <br />• Centerline of street <br />• Indicate Norih <br />• Show eny proposed grading changes <br />• Show measuraments <br />PERMIT CONDITIONS <br />1. All calln for Inapectbn shall be mede 24 hra. In advance • pho�e 259$81 �. <br />2. All work shall ba pertormed in eccordence wlth ihia permit and curtent City of Everett Design antl Constructlon <br />Standerds end Speclficatlons. <br />3. Call Locetlon Underpround Service 4B hre. bntore you dlp. TOLL FREE NUMBER 1•800�424•5555. <br />PUBLIC WORKS PERMIT <br />NOyT, �RE�UIRED <br />BY_i72 <br />DATE 2 <br />Approved fo� Construction <br />FINAL INSPECTION <br />Approved as Constructed <br />�PUBLIC WORKS DEPARTMENT <br />3200 Ceder Street <br />EveretL WA 98201 <br />Phone: 259�8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />F- <br />� <br />� � <br />� <br />� <br />O <br />� <br />� <br />O <br />a <br />The undersigned owner/applicant hereby agreas to hold and seve harm� <br />less the City of Everett irom any and a�l claims lor damages. costs, <br />expenses, or causes of action that may arise because ot installation <br />and mainlenance of the improvement or other right�ol•way use hereto <br />applied for and further agrees to remove same upon notice from Ine <br />Date City anA to replace public property damaged thereby. <br />Date - <br />Signature of Applicant �2�e <br />WORK AUTHORIZEO BY THIS PERMIT MUST BE STARTEO WITHIN <br />1B0 DAYS OF DATE PERMIT IS ISSUED AND THERE,IFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF VlORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />