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Date bi14i94 TO POSi�NG � " ���Y q <br /> PUEi¢Workc Permil• • �O _ <br /> Application For P eiec oeo�.� 44636 <br /> PUBUC WORKS PERMI�' Pu01¢WorkaFee <br /> Totei Fee s <br /> 8 leaa ADDt Fee PaiE S <br /> Print or Type Onty ¢ g g S g � g � B o�e s_ 7iC�"-' <br /> � l� P 00 �t O �O 00� <br /> M N W l� M <br /> '�' � N MN N M O <br /> Burke A M 5001 Sound Ave Evere[[ 98203" 55-6782 " '" <br /> Owner Mailing Address � ity $p � Phone <br /> �i `� `�" .tT3 `� � � x � <br /> _ Michael Burke 488-3616 � � S� � Si m S.' � <br /> Appiicant Mailing Address City Zip Phone <br /> Describe Proposed Work New house - existing house to be demolished <br /> Project Address�it known� 5001 Sound ryvv � <br /> Attach lour(4)copies of plans for proposed work- Draw to scale and note ihe lollowing as applicable: � <br /> • Property Lines • Centerline ot sireet � <br /> • Outline and dimensions of all existing and • Intlicate Norih <br /> proposed s�ructures on Ihe lot • Show any propos=d grading changes <br /> • Ezisting and proposed utilities • Show measurements � <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1.All cells tor inspection shall be made 24 hrs.in advance-phone 258•8810. � <br /> 2.All work shell be perlormed in accordence with this permit an.i current City of Everett Design and Construction <br /> Standards and Specifications. <br /> 3.Cell Location Underground Service 48 hrs.betore you dig.TOLL FREE NUMBER 1•$00�424•5555. � <br /> O <br /> � <br /> � <br /> O <br /> a <br /> � ACKNOWLEDGEMENT OF CONDITIONS <br /> ��� The undersigned owner/applicaM hereby agrees�o hold and save harrm <br /> ///'''��� less the City ol Everett rom any and all claims lor damages, costs, <br /> / L n �/�/__ //�/� expenses. or causes ac on ihat may arise because of installaiion <br /> �T�•• (� «�` �— and mai tenance of he im�rovement or other righ4ol-way use hereto <br /> � �� � �� U� applie f r and lur h agr�es to remove same upon notice Irom ihe <br /> Approved for Constrycron —, Da� Cit nn to pl c <br /> �� y du lic property damaged thereby. <br /> ��// 1 f� � <br /> /t ����1 �.� J�—. /��. 7� / � . <br /> FINALINSPECTION`-� Date � � �'d � <br /> Approved as Constructed Sign ure ol Ap ic n D le <br /> °UBLICWORKSDEPARTMENT WO K AUTHORIZED BY THIS PERMIT MUST BE TARTED WITHIN <br /> ��r� 3200CedarStreet 180 DAYS OF DATE PEFMIT IS ISSU@D AND THEREAFTER IS TO <br /> ���t Everett.WA 9820t BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> �'� Phone:259-8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON TNIS <br /> PROJECT OVER 90 DAYS DURATION. <br />