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Date 8-23�91 <br />� <br />Applicetion For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Public Wonu Wrmtl • <br />eiaa oam.. 91/27554 <br />Puenc work. fw <br />Tot�l Fee � <br />le�� AOo� Fsa P�iC i <br />Btlmn Due s <br />Relly Tolle 8220 Xavier Way Everett 98208 <br />Owner MeiNng Address Clty Zip Phone <br />John's North Sound Builders 14404 Old Hwy 99 Marysville 98270 653-2512 <br />Applicent Meiling Addreas City Zip Phone <br />Deacrlba Proposed Work _SFR add1t10n <br />Project Addresa (if known) <br />Attach four (�) copiea of plens fo� proposed work - Draw to acale and note Ihe tollowing as applicable: <br />• Property Linea �� Cenierline of street <br />• Outline enA dimennions of ell exletinp anG • Indicete North <br />propoeed structurea on the lot • Show any proposed gradinp chenpes <br />• Exielinp and propoaed utllitfea • Show measuremente <br />PERMIT CANDITIONS <br />1. All qlls for inapectlon ahell be msde 24 hrn. In advance- phone 250-8810. <br />2. All work �lull be peMormed In eccordence with thls permH end curtent City of Everett Design and Constructlon <br />St�nd�rds and 3pacifk;stlona <br />3. Cdl Location Underpround 3ervics 48 hra before you dig. TOLL FREE NUMBER 1$00�424�6bb5. <br />�..c:� �Gk� ����t /l�e� ie�c�-r�c� <br />� <br />� 23-q/ <br />Approvad for Construction Date <br />FINAL INSPECTION Date <br />Approved as Consiructad <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />Phona: 259-8810 <br />_� , <br />i r�,c:' - <br />" ` ^ ,. r <br />, .. _�- <br />. U� <br />ACKNOWLEDGEMENT OF CONOITIONS <br />W <br />H <br />� <br />The undersigned owner/applicant hereby agreea to hold and aeve herm- <br />less the City of Everett trom any and all claims for Aemages, costs, <br />ezpenses, or causes of ection that may erise because of installatfon <br />and maintenance ot the improvement or other righl•of-wey uae hereto <br />applied tor and further agrees to remove seme upon notice from the <br />Cily and to replace public property damaged thereby. <br />Signature ol Applicant � Dete <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />1B0 DAYS OF OATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON TIiiS <br />PROJECT OVER 90 DAYS DURATION. <br />