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� �Q POSTING � 10 '�' �' <br /> ApplicationFor -- �- � <br /> ' PUBLIC WORKS ,PE MIT Date 11/28/95 <br /> PUBLIC WORKS DEPARTA�ENT Public Works PertnN A QS ��_ <br /> 3200 Cedar Street xc <br /> Everett,WA 98201 259,@g10 015� <br /> � Building Parnit# 5 <br /> NPE OR PRINT ONLY 2 `� � � �" � g �' G' `' � <br /> m N r� o � o cQubl!i��Cs�ffi$- ?'�—• <br /> [4f ,�p' M a N Mi � �w �j M .�-*. <br /> ROGER OLIN CONST PO BOX 3216 E�RE7� «98203 �3�-�62U»* "� � <br /> Owner Mailing Address � Ciry ti a _. ri Phone <br /> � � � � � � � � � os�� � o � <br /> 04'I�RR ni ic o a i °�i o � � � �i :n �'S c?3 <br /> Applirant MailingAddress " Gty Zip Phone <br /> Gescribe Proposed Work NEW HOUSE - BASIC 1144 � <br /> � <br /> � <br /> PROJECT ADDRESS(if known) �� GC� l� -rf✓��r , ' � <br /> Attach four(4)copies of plans tor proposed work-Draw to scale and note ihe tollowing il applical��e: � <br /> •Property Lines 'Oulline and dimensions of all existing and proposed structures on the lot •Ezisting and proposed ulilities O <br /> 'Centerline of s�reet •Indicate Notlh �Si ow any pmposed gradim�chnnges •Show measurements � <br /> DO NOT WRITE B�LO`.'�THIS LINE <br /> PERMIT CONDITIONS: � <br /> 1. All calls for inspection shall be made 24 hours in advance- phone 259-8810. O <br /> 2. All work shall be pertormed 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. TOLL FREE NUMBER 1-800-424-5555. � <br /> j : �, DrivGw� da,vhs/o�e. rn�s�. lzy ;� � m,h;n�c�r� or� (/� <br /> � � �-�i-aM -�ie �. ed�y� o� Pztverna.�� ��-ed d�'ive�� Q <br /> � (��c rr1a� � e x� z o /d . �hsfa�/ Verf-��� � Q• <br /> G�U/'lJeJ� LL � ��� a'�U �rr/ O� f�i"l1if.it/�j S�iGtl <br /> G�-� � ca r- �«w Il/ naf dr��a� �� ,n.e..� <br /> �� F� <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> � I/1/�� /7/�� The undersigned owner/appliwnt hereby agrees to hold and save hartnless <br /> ��� ( U the City of Everetl from any and all claims for damages,costs,ezpenses,or <br /> Approv or onstruction Date causes of action ihat may arise because of installation and maintenance o} <br /> the impmvemeM or other nght-oFway use hereto applied 1or and further agrees <br /> /� to remo��e same upon notice tmm the City and to replace public property <br /> � �� ?� damaged thereby. <br /> A INSPEC Da e <br /> A�proved as Constructed <br /> �i �Ai/I � ���_ <br /> Sig at re o plican Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WIiHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLETION.THIS PERMIT N�AY BE CANCELLED 2Y THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />