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.- <br /> Applicatbn For � <br /> � PUBLIC WORKS PERMIT �a 5-29-97 <br /> PUBLIG WORKS DEPARTMENT Public Nbrks Permit N � �_ <br /> 3200 Ceder SYroet <br /> Everett,WA 98201 259-eeta 3 O � suadinq ae�mtt M 55288 <br /> TYPE OR PRINT ONLY TO POSTI NG � public Workg Fee S g�r'J� _ <br /> A1 6 Denise Lorenz 3723 100th St SE Everett 98208 338-0436 <br /> Owner Mailing Address City Zip phone <br /> Chrietopher Day, Architect 206-860-2847 <br /> ApPlicant Mailing Addiass City ZiP Phone <br /> Describe Proposed Work ne�,� house � <br /> � <br /> � <br /> PRWECT ADDRESS(if known) '� c�Ci •�r� f�( � <br /> Aflach four(d)copies of plans for proposed work-Drew to scale and note tha following if applicable: �T—�� 3'� � <br /> `Pro�xrty Lines �Outline and dimensiors of all existing and proposed structures on the bt •Existing O <br /> 'Centerline of street •Indicate North •Show any proposed grading changes 5how measu •� � <br /> I16 112.00 <br /> DO NOT WRITE BELOW THIS LINE . <br /> PERMITCONDITIONS: Slll{qRfiE 4,Sp � <br /> 1.All calls for inspection shall be made 24 hours in advance-phone 259-88��11A1' Z0.00 <br /> 2.All work shall be pertormed in accordance with this pertnit and current City of Everett D��§3 and � <br /> Construction Standards and Specifications. yp� �p,pp <br /> 3.Call Location Underground Service 46 hrs. before you dig. TOLL FREE PAIMBER 1-801i�i14-5555. � <br /> SEl�lt ?0.00 <br /> �� Ty���t i�� ��� �,� �,�N� -� �M ����.�� v� <br /> ��{,,,, �,F r�. TOTAL �136.10 <br /> v���`� CHEK 1 0 <br /> A OIS1236 <br /> / ���, L'a� <br /> I ;!� �c��'�'L � <br /> .���;" ��/ i � ����� d�� � <br /> � � oT_ � o� ,_� <br /> r�,:__ �a,� <br /> � �'d� '�; �� � /�m� `— � �' <br /> � - "� �� �// � <br /> , <br /> ACKNOWlED6EMENT OF CONDITIONS <br /> i The undersig owner/applicant hereby aprees to hold and eave hamtless <br /> � � the City of E � tt from any and all claima for dameges,costs,ezpenses,a <br /> d for Consiruction Date causes of a ion that may arise because o1 InstelWtbn and maintenance of <br /> iheimprov torothcrright-of-way heretoappliedforandlurtheragrees <br /> to remove:� me upon notice irom Clty to replace public p�operty <br /> damag �t by. <br /> FINAL INSPECTION Date <br /> Approved as Constructed <br /> � <br /> Signat Applicanl Date <br /> WORK AUT}iORIZED BY THIS PERMIT MUST BE STARTED WIIHIN 180 DAYS OF DATE PERMR IS ISSUED AND T1IEREAFTER IS BE DILICiENiLY PURSUED TO <br /> COMPLETION.h11S PERMIT MAY BE CAN(:ELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PRQIECT OVER 90 DqVS W RA710N. <br />