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/ . <br /> - ApP�icalion For <br /> � PUBLIC WORKS PERMIT Date 1-z1-9� - <br /> PUBLIG WORKS DEPARTMENT Public N'orks Permit F __�1�y2� <br /> 3200 Cedar Street 54003 <br /> Everett,WA 98201 259-8810 Bui!ding Permit k — <br /> R� n��T�Nr OCr � 6 1997 PublicWo:ksFeeS aD�� — <br /> TYPE OR PRINT O�!LY <br /> Otto Brixel 1210 96th Ave SE Everett 98�205 334-167Z'P ahone <br /> Owner Malling Address Y <br /> � Same Zi Phone <br /> Applicant Mailing Address City P <br /> Describe Proposed Work espresso stand W <br /> � <br /> �//� <br /> �f♦ <br /> PROJECT ADDRESS(if known) �03C7 — •S/ � ��- � <br /> Attach tour(4)copies of plans for proposed work•Draw to scale end note the following if applicable: O <br /> •Property Lines 'Outline and dimensions of all enisting and proposed siructures on the lot •Existing and proposed utilities � <br /> •GenteAine of street •Indicate NoAh •Show any proposed grading changes •Show measureme�ts <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS: O <br /> 1.All calls for inspection shall be made 24 houra in advance-phone 259-8810- <br /> 2.All work shall be performed in accordance with this permit and current City of Everett Design and <br /> Cons'ruction Standards and Specifications. � <br /> 3.Cali Location Underground Service 48 hrs.before you dig. TOLL FREE NUMBER 1-800-424-5555• <br /> O � a?/— P�G/� '" '_9�'�'i ..:-L�.�.: r�,.r._�N'r:" �/��. :. <br /> � ���� G��!-�'f �o p2 f/ph E � --' _ .. .. O <br /> �/ /_2S�- 9 7 ����09"ll°4 /� <br /> �pP�,-n��c _ ..n. - Ii� <br /> / '. ,'' <br /> _-_ ,_n <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees tu hold and save hartnless <br /> / a 9—% � ihe City of Everett from any and all claims for damages,costs,ezpenses,or <br /> ` ' causes of action that ray arise because of installation antl maintenance of <br /> Approvedfo o n Date theimprovementorotherright-cf-wayoseheretoappliedforordPoAheragrees <br /> � � ?%,�• to remove same upon noticc from the Ciry and to repiace ublic property <br /> 3 ,� �' S damaged Ihereby. <br /> 'i n <br /> FI IN C 10 � � Date � a�. ��� <br /> qpproved as Constructed , <br /> D <br /> Signature of Applicant <br /> COMPLET ON.TIHES ERMIT M.YRBE CA�ICELLED BYTHE CITYIUPON�ANV SOTOPPAGE OF WOP.K ON 71iIS f'ROJEC OVEF 90 DA S DURIATION.Y PURSUED TO <br />