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TYPE OR PRINT ONLY <br />Jeff <br />Apphoation For <br />PUBLIC WORKS PERMIT <br />PUBLIC WORKS DE°ARTMENT <br />320o Ceda, S,reet <br />Everett, WA 911201 259-8810 <br />TO POSTING N v 2 ° n <br />PO Box 716 Everett 98206 425-252-3699 <br />Owner Mailing <br />Owner <br />Applicant Mailing <br />Describe Proposed Work new house <br />PROJECT ADDRESS (if known) 4639 Seahurst Ave <br />Dare 3-5-99 <br />Public Works Permit 0 Q <br />Building Permits_ gq611�Z71 <br />Public Works Fee S ZZ) <br />Zip <br />city Zip phone <br />Lot 3 SP 1-98 <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the following If applicable: <br />*Property Lines "Outline and dimensions of all existing and proposed structures on the lot 'Existing and proposed utilities <br />aCentedine of street •Indicate North 'Show any proposed grading changes `Show measurements <br />PERMIT CONDITIONS: <br />1. All calls for inspection shall be made 24 hours in advance <br />- phone 259-8810. <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and <br />Construction Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. <br />TOLL FREE NUMM 1-BDO (424-5515& <br />H <br />61771 <br />WILD <br />860.75 <br />PLUIM3 <br />91.00 <br />MECH <br />60.00 <br />SRCHG <br />4.50 <br />DRIVE <br />20.00 <br /># <br />31878 <br />SEWER <br />70.00 <br />UTILITY <br />1296.00 <br />TOTAL <br />2402.25 <br />A OM 913 <br />W <br />H <br />Im <br />O <br />M2 <br />z <br />O <br />O <br />a <br />CHEK 2402.25 <br />ACKNOWLEDGEMENT OF CONDmONS <br />The undersigned owner/applicant hereby agrees to hold and save harmless <br />the City of Everett from any and all claims for damages, costs, expenses, or <br />causes of act n that may arise because of installation and maintenance of <br />the improvement or other right-ol use hereto applied for and further epees <br />to remove same upon MUM from the City and to replace public property <br />damaged thereby. <br />FINA INSPECTION Date <br />Approved as Constructed <br />3 ZS <br />l cant <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE VpErT4 <br />IS ISSUED AND THEN IS TO BE DILIGENTLY PURSUED TO <br />COMPLETION. THIS PERMIT MAY BE CANCELLED 3Y THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER go DAYS DURATION. <br />