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� <br />TYPE OR PRINT ONLY <br />Desr.ribe Proposed Work <br />� \pplication For <br />PUBLIC r✓ORKS PERMIT <br />PUBLIC WORKS DEPAHTMENT <br />3200 Cedar Street <br />Everett, WA 98201 259-8810 <br />PROJECT ADDRESS (if known) <br />a 1621 Baker Ave Everett <br />Mailing Adtliess <br />Mailing Address <br />remodel, addn 6 garage <br />_ 4626 Seaharst Ave <br />Date 11-25-96 <br />Public Works Pertnit N <br />Building Permit p _ 53593 <br />Public Works Fee $ _ <br />or <br />Attach four (4) coples of plans for proposed work - Draw to scale and note the following if applicable: <br />'Property Lines 'Outline and dimenslons of all ezisting and proposetl structures on ihe lot •Existing and proposed utilities <br />'Centerline of sireet •Indicate North •Show any proposed grading changes •Show measurements <br />PERMIT CONDITIONS: � � � ��v ���" <br />1. All calls for inspection shall be made 24 hours in advance - phone 259-8810. <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and <br />Conshuction Standards and Specifications. <br />3. Call Location Underground Service 48 hrs, before you dig. TOLL FREE NUMBER 1-800-424-5555. <br />/ " b � ,l�'P1��1'I' T �✓ �v� <br />V F> <br />V <br />Approved for Construction Date <br />FINAL INSPECTION Date <br />Approved as Constructetl <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The untlersigned owner/applicant hereby agrees to hold and save harmless <br />the City of Everetl from any and all claims for damages, costs, expenses, or <br />causes o1 aclion that may anse because of installation and maintenance o( <br />the improvement or other righbof-way use hereto applied for and further aqrees <br />to remove same upon notice from the City and to replace public property <br />damaged thereby. <br />Signa�ure of Applican� Da�e <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO <br />COMPLEf10N. THIS PERMIT MAY BE CANCELLED BY 7HE CITY UPON ANY STOPPAGE OF WJRK ON THIS PROJECT OVER 90 DAYS DURATION. <br />