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Date <br />Application For <br />PUBLIC WARKS PERMIT <br />Print or Type Only <br />Owner <br />Applicant <br />Describe Proposed Work <br />Project Address (if known) <br />� Puolic wo�ka Paimlt • <br />Bieo. Deo� • _ <br />PUEIic Worb Fee s <br />TotalFee <br />Less ADD� Fee V�'i0 S <br />B+�ance Oue S <br />rtan �necx no: n qyuo� y��,q <br />Applicat.Date: 07/27/95 <br />_ Job Addrese: 5302 RUCKER AVE <br />Owner: LECHNER DWIGHT <br />Tenant: <br />Proposed Use: GARAGE <br />Deec. of Work: <br />— NEW DETACHED GARAGE <br />OFFICE SET JOB SET <br />APPROVED FOR PERMIT: DATE_/_�_ gy <br />Attach four (4) copies ol plans tor proposed work • Draw to scale and note the lollowing as applicable: <br />• Property Lines <br />• Outline and dimensions oi all existing and <br />proposed structures on the Iot <br />• Existing and proposed utilities <br />V� <br />• Centerline ot street <br />• Indicate North <br />• Show any proposed grading changes <br />• Show measurements <br />Phone <br />Phone <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hrs. in advance - phone 259•8610. <br />2. All work shall be pedormed in accordance with this permit and current City of Evermtt Design and Construction <br />Standards and Specilications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-B00•424•5555. <br />'UBUC YJORK� PERMIT <br />tIGT REOUTAEtI <br />./ <br />4Y_.,- - <br />�•IATE 7 9 S <br />Approved for Construction Date <br />FINAL INSF'ECTION Dale <br />Approved as Consiructed <br />�Ar!�� PUBLIC WORKS DEPAFiTMENT <br />3200 Cedar Street <br />` EveretL WA 98201 <br />Phone: 259�081U <br />ACKNOWLEOGEMENT OF CONDITIONS <br />� <br />O <br />� <br />Y / <br />O <br />a <br />The undersigned owner/applicant hereby agrees to hold and save harm� <br />less ihe Cily ol Everett Irom any and all claims for darnages, cos�s, <br />expenses, or causes ol action that may arise because ol installation <br />and maintenance ol Ihe improvement or olhcr riyht-of-way use heieto <br />applied for and lurther agrees �o removr, same upon nolice from the <br />City and to replace public property damaged lhereby. <br />Signature ol Applicanl Date <br />WORK AUTHORIZED BY THIS PEFlMIT MUST BE STARTED WITHIN <br />180 DAYS OF D�7E PERMIT IS ISSU[D AND THEREAFTER IS �TO <br />OE DILIG[NTLY FURSUED TO COMPLETION. THIS PERMIT MAY 8E <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS OURATION. <br />