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. - . <br /> Date1X 14/85 a�ei��wo,wsae,m�i. ��"�� <br /> Appliwtion For Biaq.oeo�.•�15571 <br /> PUBLIC WORKS PERMIT Pu0licWo�ksFen <br /> Totel Fee $ <br /> LCSs Appl FCe Pdld S <br /> Print or Type Only B"°"°°o°° $� <br /> S'�3 �— <br /> Marina A. Magpatoc 2222 t9etmore Everett 98201 252-9159 <br /> Owner Mailing Address Ciry Z�p Phone <br /> Same <br /> Applicant Mailing Address City t�p Phone <br /> Describe Proposed Work COnStrUCt Single Fdmily GaYdge <br /> Project Address(if known) z222 Wecmore � <br /> Attach four�4)copies ot plans for proposed work- Draw to scale and note the following as applicable: � <br /> • Properry Lines • Cenlerline of street � <br /> • Outline and dimensions of all exisling and • Indicate North <br /> proposed structures on the lot • Show any proposed grading changes <br /> • Existing and proposed utilities • Show measurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS O <br /> 1. All calls for inspeclion shall be made 24 his. in advance- phone 259•881 5. � <br /> 2. All work shall be perlormed in accortlance with this permit and current City of Everett Design and Construction <br /> Standards and Specilications. � <br /> 3. Call Localion Underground Service 48 hrs.belore you dig.TOLL FREE NUMBER 1•800-424-5555. � <br /> O <br /> � <br /> � <br /> O <br /> a <br /> ACKNOWLEOGEMENT OF CONDITIONS <br /> �Jt� The undersignetl owner/applicant hereby agrees to hold and save harm- <br /> less the City ot Everelt from any and all daims lor damages, cos�s, <br /> �/�' r expenses, or causes of action Ihat may anse because oi inslallation <br /> �-�����vc� ��i c� ,� and maintenance of lhe improvement or olher righFobway use hereto <br /> applied lor and furlher agrees to remove same upon notice irom the <br /> Approvetl tor nstrudion f/ Date City and to replace public property damaged thereby. <br /> Jl�3eeT��� / �-`'� (/�p,�� � �7 �, __ <br /> �'��'`�1'a`�' /l //l� <br /> LINSPECTION Date `� T��'�^-�� �"�'���-. � Z <br /> Approved as Construcled Signature of Appliwnt (,�Date � <br /> everetl PUBLIC WUfiICS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WIiHIN <br /> � 3200 Cedar Street 180 DAVS OF DATE PERMIT IS ISSUED AND TFiEREAFTER IS TO <br /> Everett,WA 98201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAV BE <br /> Phone: 259�8R75 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> I PROJECT OVER 90 DAYS DURATION. <br />