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g � <br /> � "voucanoo F« B/27/97 <br /> PUBUC WORKS PERMI'� °a,a <br /> PUBLIC WORKS OEPARTMENT Y Public`Norks PertnN N <br /> 3200 Ced�r Streei W Z$7 <br /> Everett,WA 982G7 259-8810 z guilding Pertnit N 56353 <br /> � <br /> NPE OR PRINT ONLY Pub�ic Works Fee S `35�� -- <br /> � M � � m BK <br /> THORSEN R0� 2311 TAYLOR DR EVERE7'T QB�P � 3�4916 <br /> Owner '�' Mailing Address �ttY ¢ Z�P �O� <br /> ►o:3v fr�day a J <br /> m iC 6 <br /> Q <br /> qpplicant Mailing Address p„ �!� Zip Phorre <br /> os � h` <br /> � <br /> Describe Proposed Work RESURFACE�ACE OF BLDG — SIDEWALK REPAIR � <br /> Fi'�Lac� sidc.walk �ir, �'r+ovrh o+�' B�� 'td, v+e _ <br /> —�— � <br /> � ��� � � � <br /> --=�--� <br /> PROJECT ADDRESS(ifknown) 3116 RUCKER AVE � <br /> Attach four(4)copies of plans tor proposed work-Draw to scale and note the folbwing il applicable: O <br /> •Property L.nes 'Outline and Eimensions ol all existinp and pmposed structures on tlw lot �Existing and proposeA ulilities <br /> `Centerline of street •Indicate North 5how any proposed graEing changes •Show measurements � <br /> DO NOT WRITE BELUW THIS LINE � <br /> PERMIT CONDITIONS: <br /> 1.All calls for inspection shall be made 24 hours in advance-phona 259-8810. O <br /> 2.All work shall be performed in accordance with tfiis permit and current City of Everett Design and <br /> Construction Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOL4 FREE NUMBER 1-800-424-6556. � <br /> 4. 5 � c(cwaCL� �o �c� groom �nis� � <br /> S. 5 �dec.�nCk fo sCoPe af /z:� as s/�oc.i.. ovi O <br /> Q774C �)t [� uYac✓/n� . � <br /> ACKNO`NLEOGEMENT JF CONDITIONS <br /> ��� The undersigned owne�/appfcant hereby agrees to Mltl and save hartnless <br /> ��� 'z the Ciry o!Evereri from any and ail claims ta dama9es,costs,ezpenses,or <br /> rove C st ion ate �uses of action that may arise because of installation and malntenance of <br /> P 9 �' thelmprovemantorotherright-of-wayus5heretooppliedforanAturtheragraes <br /> ( to re n notice fiom the Cify anC to replace puWic�xopeAy <br /> � B�� aged thereby. <br /> FINAL IN5PECTION �Date <br /> qpproved as Consiructed <br /> Signature of li t �'�'-- <br /> WORK AUTFiJRIZED BY TI IIS PERMIT MUST BE S7ARTED WITHIN 180 i��`.YS CF DATE PERMIT IS I U AND THERl:AFTEP IS TO BE DILIGENTLY PURSUED TO <br /> COMPLEf10N.THIS PERMIT MAY BE CANCELLED BY 1HE CIN UPON A�Y>�^^�AGE OF WORK ON THIS PRQIECI OVER 90 DAYS OSIRATION. <br />