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x. <br /> � . / <br /> Date 8-16-90 � „ <br /> �liC\YO�FS PYfTi�� _���9�� <br /> $ Apphcation For eiag ocn��• 90/1.5412 <br /> PU�IiC WORKS PERMIT P�^°�W�«�F�a <br /> iotal Fe> $ <br /> O LeaS Pppl.Lee Parp fJ , <br /> O <br /> Print or Type Only pp .p p <br /> $ $ g � � g $ S� eaia�«o�r S_20� <br /> .�p O N � M N � �Np. <br /> O M M M N M N N h <br /> Duane Smith � 89 `u — 56th P1 W P I�ukilteo 98274 353-6606 <br /> Owrer � i i � City Zin Phone <br /> owner o n'S � �' � m �:� <br /> .. <br /> Applicant Mailing Address City Zip Phone <br /> Describe Proposed Work ��StxUCt neW dUp1eX <br /> Project Address(il hnown) 5610 A & B SeahuZst AVe. � <br /> � <br /> Attach lour(4)copies ol plans for proposed woik- Draw to scale and note the lollowmg as applicable�. � <br /> • Property Lines • Cenlerline ol st�eet � <br /> • Oulline and dimensions ol all exisfing and • Indir.ate North <br /> proposed structures on ihe lot • Show any pronosed gradiny changes <br /> • Exisling and proposed utilities • Show measurements � <br /> DO NOT WRITE BELOW THIS LIN[ O <br /> PERMIT CONDITIONS <br /> 1.All calls for inspection shall be maoa 24 hrs.in advance-phone 2b9-88S 0. � <br /> 2.All work shall be pedormed in accordance with this permit and current City ol Everett Design and Consiruction <br /> Standards and Specilications. <br /> . 3.Call Location Underground Serv�ce 48 hrs.belore you dic�.TOLL FqEE NUMBER 1•80�•424•555�. � <br /> O <br /> � <br /> N <br /> O <br /> a <br /> �G:NO1�L[DGEMEtJI OF CON�I7lONS <br /> 7b��unders�gneA uwneUapplicaN hereby agrees�o hold antl save harm- <br /> -- - �dss ihe City of Hverelt from any and all claims lor damages, costs, <br /> ezpenses. or causes of action that may arise because of installalion <br /> !V,e- ��-1r�'9L1 and mamtenance ot the improvement or othe� right�ol-way usr. nere�o <br /> applied lor and lurther agrees to remove same upon notice Irom the <br /> Approved for Constructi _. y� �/Da}e,/ City and t�replace public property damaged thereby. <br /> �1�.�� _ /���� � <br /> FINAL INSP[CTION Dale <br /> Approved as Conslructed Signature ol Applicant Date <br /> everett PUBLIC WORKSDEPARTMENT N�ORK AUTHORIZED BY THIS PERMIT MUST BE STAfiT[D WITHIN <br /> � 3200CedarStreet � 180 DAYS OF DATE PERMIT IS ISSUED AND THEHEAFTER IS TO <br /> Everelt,WA 98201 BE DIUGENTLY PURSUEU TO COMPLETION. TNIS PERMIT MAY �[ <br /> Phone:259-8810 GANCGLLEG �Y THE CITV UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJtCT OV[R 90 OAYS DURAiION. <br />