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�te �-9-94 <br />qpplication For <br />PUBLIC WORKS <br />Print or Type Only <br />Dave <br />Owner <br />Memng <br />� <br />c*�'! r. <br />Ye Po.: <br />�. � <br />(�RMIT <br />Q <br />O <br />PuElic Works Permit • 7 D / <br />_'�.ZZ� . I �IGO.Devl.��'�96'� <br />� v4i no� ��u�iooc� <br />�� . . . y <br />��i,�, v�i m��y'^va riw' t <br />H N M M <br />CJ '_ _ _�l,_ <br />.�r� � �`+x� � � v <br />�� �UW6_ �UCL JS <br />��y d ti�i tf)r�hr� n.CJ <br />Publ¢ WOM1� Fee s -� <br />To1sl Fee <br />Les� ROG� Fee Pe�d s�� <br />9elenceDue s Z�.O� <br />Describe Proposed work PBve parking apaces off alley for conversion to tri lex <br />5916 <br />Project Address (if knowN -- <br />Attach four (4) copies ol plens tor proposed work - Draw to scale and note the following as applicable: <br />• Proper y Lines <br />• Outline and dimensions of all ezisting and <br />proposed st�uctu:es on Ihe lot <br />• Ezisting and proposed utilities <br />• Centerline of street <br />• Indicate North <br />• Show any proposed greding changes <br />� 5how measurements <br />�rl ve��rt <br />U ' <br />PERMIT CONDITIONS <br />1. All cells for inspection ahell be mede 24 hra. in advence - phone 259�8810. <br />2. All work ahell be perlormed in eccordance with thia permit end current Cily of Everett Design end Construction <br />Stenderda and Speciticetions. <br />3. Call Locetion Underground Service 48 hrs. before yau dig. TOLI FREE NUMBER 1•800�4i4555 . <br />��c <br />Approved as Conslructed <br />�PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett. WA 98201 <br />Phone: 259•8010 <br />y�� <br />� <br />O <br />� <br />� <br />O <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersignetl owner/applicant hereby agrees lo hold and seve harm• <br />less the City of Everetl irom any and all claims tor damages, costs, <br />ezpenses, or causes ot action that may arise because of instaltation <br />b�d maintenance of Ihe improvement or other right-of•wey use hereto <br />ypplied for and further agrees to remove same upon nolice from the <br />Cit�a pA �o replace p�c property damaged thereby. <br />�/ � i��i�M� <br />S�9f1 fufC O� hVVucain <br />WO K AUTHORI2ED 8Y THIS PERMIT MUST BE STARTEO WITHIN <br />1 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />PROJECT OVER 90 DA S DUFATION. STOPPAGE OF WORK ON THIS <br />