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. �( <br /> µ�non�o„Fo, Date S fy fog _ <br /> � PUBLIC WORKS PERMIT public Works Pertnit M �,9��4 <br /> PUBLIC WORKS DEPARTMENT <br /> 3200 Cedar Street 62362 <br /> Everetl,WA 98201 (425)257-8810 Building Pemtit A <br /> TYPE OR PRINT ONLY �z s—zouo gN I1SOd Ol Public Works Fee S ZD <br /> RONALD MIGAS 6126 139TH PL SW EDMONDS 98026 425-742-6693 <br /> Owner Mailing AdAress City Zip Phone <br /> Appiiwnt Mailing AdAress Ciry Zip Phone <br /> Describe Proposed Work NEW HOU E W <br /> �,it-].a-'9 _ : a�,1 � <br /> N �6:3E:' <br /> �.�_ ir,e,l.� � <br /> .,,� _ � , .irD <br /> Sn���,.:�„ M <br /> PROJECT ADDRESS (ii known) � SILVER LAKE RD W <br /> f�l: �. :. . .�..Tj O <br /> �I � <br /> Attach four(4)copies plans Por proposeA vrork-Drew to scale end nole the following if epplicable: � " � <br /> •properry Lines •Outline end dimensioas o1 ail existing end proposed strudures on the lol •E�Isting enA prbposed utilitles'_' <br /> •Centedine ol sheet •Indicate North •Show any proposed greding changes •Show measurements � - - <br /> DO NOT WRITE BELOW THIS LINE , � <br /> PERMITCONDITIONS: � ' ' O <br /> 1. All calls for inspection shall be made 24 hours in advance - phone (425) 257-8810 <br /> 2. All work shall be pertortned in accordance with this pertnit and curzent City of Everett Design and � <br /> Construction Standards and Specifications.. <br /> 3. Call Location Underground Service 48 hrs. before you dig.TOLL FREE NUMBER 1-800�424-SSSS. /A <br /> \/♦ <br /> /I IY���I i�{p��jpris��C erDSiOv+ G�n'�al '�D �7^Gl1Gr+t O <br /> �'f � I f 1 <br /> Sr�-�j ►'�►� o-F� -� �-�.-,,� -�-ti-� �� �, a <br /> S S�d.c se� �f p�' s� P ►aH �c� ►- <br /> �� ��-� �t;� ;9,�My ,���f � � � �f -� � o� ;,�.� <br /> ,rtdj�+«, t P�a�-�;pr. <br /> � ',.�ry'�./ <br /> ACKNOWLED6EMENT OF CANDRIONS <br /> /�' fie un0arsipned ownedepplkaM Mreby eprees to hold end eave hermlese <br /> Cie Ciry ot Everett trom arry and ell clelms For demapea,cosffi,eKpenseo,or <br /> r v or �ns c ion a e �a�s�g oi e�n«,me�may ane�necs�,.B a u�s��uor�.na�boe�a me <br /> � ^ improvement rn Wher ripht�of-way uae Mreb applbd br an0lu�er apreee b <br /> J /� � I remove eame upon ratice lrom tne Gry end b rcWace D��MaPeM��^• <br /> FJ• /c / __ l! �a-z�- 99 a9ed thereb <br /> FINAL INSPECTION V Date � _ � <br /> Approved es Constnicted <br /> WO(iKAUh10R�BY7TNSPEAMIiMUSTBESTAFiTEDWfT}11�J1BODAYSOFDMEPEH�fi15 MO IS70�D�X8rTLYR/Iffi1�T'" <br /> OOfrR�LETION.TMS PERMfT M+1Y BE GVJCFILED BV TFE qTV U�'ON ANY ST4PPMOE OF VYI�F!(ON TFIIS PNO�ECTOVEA YO DAVS OUNRpN. ' <br />