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Date 5/17/85 <br />' � Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Oniy <br />Sandy Maclam <br />O�� ner <br />�pip6X Goode Const Co <br />Fpplicant <br />12117 Sth Avenue S.E. <br />Mailing Fddress <br />5832 119th Avenue N.E. <br />Mailing Address <br />noollc woika Pcrmit : :� ��' �S/ <br />eiae.oeoi-• 8S/14868 <br />PuCI¢WodaFee S <br />Total Fee <br />LC55 AO�I. FM Pd10 � <br />o.,i.�«o�o S ��'i,�'G <br />7 b' �?�' <br />Ev�rett 337-9336 <br />Zip Phone <br />Lake Stevens <br />Zip <br />Describe Proposed Work 5109 Wilmington — Construct Garaae and Parki.iq <br />Pwject Address (il known) <br />5109 Wilmington� <br />Attach four (4) copies ol plans lor proposed work - Draw to scale and note 1he following as applicable: <br />• Property Lines • Centerline of street <br />• Outline and dimensions of all eaisting and • Indicate North <br />proposed s�ruclures on the lot • Show any proposed grading changes <br />• Eaistino and proposed utilities • Show measuremeNs <br />LINE <br />334-9262 <br />Phone <br />PERMIT CONDITIONS <br />1. All calls tor inspection ahall be made 24 hrs. in aCvance - phone 259•881 5. <br />2. All work shall be performed in accordance with ihis permit and wrrent City oi Everett Design and Consiruction <br />Standards and Specifications. <br />3. Call Location Untlergwund Service 48 hrs. betore yeu dig. TOLL FREE NUMBER 1-800•424•5555. <br />� <br />/� <br />FINAL INSPtGiIUN <br />Approved as Constructed <br />everelt PUBLIC WORKS DEPARTMENT <br />� 3200 Cedar Sireet <br />Everetl, WA 98207 <br />Phone:259�8�15 <br />W <br />H <br />� <br />� <br />� <br />O <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less Ihe City of Everett irom any and all claims lor damages, costs, <br />eapenses, or causes ol action thal may arise because of installation <br />and maintenance ol the improvement or olher right-ol�way use hereto <br />applied lor and lurther agrees to remove same upon notice from Ihe <br />City and to replace pubiic prope�ty damaged thereby. <br />. , . � <br />Date'� /�� G/ii'✓� _ cx— '�`0 i <br />Signa ure of Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATF PERIJ�IT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY P�1RSU[D TO COMPLETION. THIS PERMIT MAV BE <br />CANCELL[D BY THE CITY UPON ANY STOPPAGE O� WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />