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�i7i � �ii <br />«i <br />H <br />�HV� <br />K�C~') <br />H71 <br />"�9 M'il <br />NNrr <br />� Q � <br />OH <br />��g <br />Q. :-� <br />t"y� <br />�yH <br />�� y <br />O t�n <br />� <br />I �� <br />�� <br />�8[2— <br />(�ppIIC0I100 FOf <br />PUBLIC WORKS PERMIT <br />Print or Type Oniy <br />Owner <br />Applicanl <br />Describe Proposec <br />Plan Check Wo: 6 38598 SEPA <br />Applicat.Date: 11/04/92 <br />Job nddrs: 3802 t4ETMORE AVF. <br />Owner: SHERLOCt: MICHAEL 6 DEBBIE <br />Tenant: <br />Proposed Cse: SINGLE FAMILY RESIOENCE <br />Desc. of Work: <br />SFR ADDN <br />OFFICE <br />J06 SET <br />APPRVD FOR PERt1IT: DATE_/_/_ BY <br />Prolect Address (it known) <br />�ub�.c ��'n.�i P�•m�l • <br />pidq DrO� � � <br />P�oi¢wonsree S <br />Touiiee <br />Lesf �ool fee va�e 5 <br />BaienceDue S <br />Atlach lour I41 copies o� plans br proPosed work - Draw to scale and note Ihe lollowing as ap,^.' oa61e�. <br />• Properry Lines • Centerline ol sireet <br />• Oulline and dimensions ol all existing an0 • Indicate North <br />proGosed struciures on ihe lot • Show any proposed gratling changes <br />• Ezistmg and proposed utilities • Show measurements <br />Phone <br />Phone <br />PERMITCON�ITIONS <br />7. All calls tor inspection shall 6e ma0e 24 hrs. in advance • phone 259•8810. <br />2. All work snall be pertormetl in accordance with this permit and current Ciry ol Everetl Design and Construction <br />Slandartls and Specilications. <br />3. Call Location Underground Service 4B hrs. hetore you dig. TOLL FREE NUMBER 1•B00•424•5555. <br />Approvetl for Construction <br />PUBLIC WORHS P[RMIT <br />NOT REOUIRED <br />D Y � �' � <br />D�7E � -- <br />Date <br />FINAL �NSPECiION Daie <br />qpproveC as Cons�rucled <br />,��C�� PUBLIC WOFKS DEPARTNENT <br />� 3200CetlarStreet <br />� Everett,YJA9B201 <br />Pnone'.259-8810 <br />� <br />O <br />� <br />Y / <br />O <br />a <br />�CKNO�NLEDGEMENT OF CONDITIONS <br />The undersi�7ned owneqapplicanl hereby agrees to hold and save harm� <br />Icss the Cily ol Everet� irom any and all claims lor damages, cosis, <br />eapenses, or causes ol action ihat may arise because ol installation <br />and maintena�ce of ihe improvement or other right-ol�way use herelo <br />applied for and lurther agrees to iemo�e same upon notice Irom the <br />Ci�y and to rep�ace puGlic property damaged thereby. <br />Siynature ol ApPlicant Date <br />WOPN AUTHORIZED DY THIS PERMIT MUST BE STARTED WITl1iN <br />180 DAVS OF DAiE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BF DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANG[LLED BY THE CITY UPON ANY STOPPAGE OF WOFiK ON THIS <br />FROJECT OVER 90 DAYS DURAiION. <br />