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Date <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Owner <br />Applicant <br />�escribe Pioposed Work <br />PrOlect ACCre55 pl known! <br />Plan Check No: B 45481 SEPA <br />Applicat.Date: 09 06/94 <br />Job Addreee: 48 3 WILMINCTON <br />Owner: HELTON CLARENCE <br />Tenant: <br />Propoeed Uee: CARPORT <br />Deec. of Work: <br />CARPORT FOR R.V. <br />OFFICE SET JOB SET <br />APPROVED FOA PERMIT: DATE!/_/_ HY <br />Attac� lour (4) copies ol plans tor propused work � Drav. <br />• Property Lines <br />• Outline and dimensions ol all esistmg and <br />proposed structures on ihe lot <br />• Existing and proposed utillties <br />fa �r.aL� .�nn no�e tha fo�icwing as apUlir.ab�e: <br />CUL�6 Worha P�rm�l • <br />Biaq Deo�. � _ <br />Puebc wo,b Fee <br />TOtTI <<p .S <br />ll53 �ppl Fee Pa�O S �� <br />BibnCp�uC .S <br />• CenteNine ol sVeet <br />• Ictlicat� Norlh <br />• �how any cr000seA yrading changrs <br />• Show measurements <br />Phone <br />Phone <br />PERMIT CONDITIONS <br />t. All calls lor inspection shall be made 24 hrs. in advance - phone 259-8810. <br />2. All work shall be peAormed in accordance with this permit and current City of Everett Design antl Construction <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800-424-5555. <br />Construcuon <br />FINAI INSPECTION <br />Approved as Constructed <br />PUBLIC WORKS PERMIT <br />NOT R pUIRE� <br />�Y B <br />�ATE 9 <br />ACKNOWLEDGEPdENT OF CONDITIONS <br />� <br />O <br />� <br />� <br />O <br />a <br />The undersignetl owner/apphcant here6y agrees lo hold and saae harm� <br />---" � less U�e City ol Everett hom any and all claims lor Camages, cosis. <br />; e+penses. or cau5es ol action that may aris= because of installalion <br />'�, and mamtenance o! the �mprovement or other righhobway use hereto <br />i appi�r;d for and fwther agrees to remove sa�^ upon notice Irom the <br />Date ; G:�� .v:d to replace Dublic property damaged +reby. <br />Date <br />ie OI AppGCan! <br />Date <br />�Ar� PUBLIC WORKSDEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />790 DAYS OF DATE PERMIT IS ISSUED ANO THEREAFTER IS TO <br />3200CedarSlreet � BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT t.1AY BE <br />EvereN. WA 98201 , CANCELLED BY THE CITy UPON ANV STOPPAGE OF WORK ON THIS <br />Phone: 259-8810 i PROJECT OVER 90 DAYS DURATION. <br />