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D2te 6/25/90 <br />� <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />�� <br />Puobc woixe permn • <br />eiav oao�. • �Cl/�G963 <br />PueLc Works iae <br />TolelFee S <br />les9 ApO� Fee Pa�d S! <br />BdIpfICpD11Q i <br />Ervin Hoglund 615 Wetmore Everett 98201 259-2735 <br />Owner Mai{ing Address Cit <br />Y ZiP Phone <br />Mailing Address <br />Describe Proposed Work �d�n to SFR <br />Prolect Address (il known) <br />Attach four (4) copies ol plans for proposed work • Draw to scale and note the following as applicable: <br />• Property Lines <br />• Outline and dimensions of all existing and <br />proposed strucWres on the lot <br />• Exiating antl proposed utilities <br />• Centerline ol street <br />• Indicate North <br />• Show any proposeA grading changes <br />• Show measurements <br />PERMIT CONDITIONS <br />1. All cails for Inspection shall be made 24 hrs. in advance • phone 259•8810. <br />2. All work shall be pertormed in accordence with this permit and current City of Everett Design and Construction <br />Standerds end Specificetions. <br />3. Cell Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800-424�Sb5S. <br />Approved far Construction Date <br />FINAL INSPECTION Date <br />Approved as Constructed <br />everett PUBLIC WORKS DEPARTMENT <br />� 3200 Cedar Sireet <br />Everett, WA 98201 <br />Phone:259-8810 <br />(�-z9 <br />���� <br />C'���-�--�". . m� <br />��,jw� �e7�ntc!-�� ��� <br />�e%r��<�) e���, P <br />W <br />� <br />� <br />� <br />� <br />� <br />� <br />� <br />� <br />a <br />The u �•�J {�,r`" '/���/� I save harm- <br />less �O �� ages, costs, <br />e%pQ1 � installation <br />and o� .............._,. _. .. _ , � use hereto <br />applied lor and lurihe� agrees to remove same upon notice from Ihe <br />City and to replace public property damaged thereby. <br />Signature ol ApplicaN Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE �TARTED WITHIN <br />180 DAYS OF DATE PERAIIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLV PURSUED TO COMPLETION. THIS PERMIT MAY B[ <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />