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Date_ '/95 5ti � b �9yb <br />ApplicationFor '�G ?QSTING_.----- <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />%rz9%c /+�.t� �905�(� <br />S.�M! r��n�o. ���n.Q90 <br />% <br />PueLc Wmhs Permit • � S - <br />BiEp Deol. • <br />vuoec Worka Fee <br />iotei Fea S <br />less �pDL Fae PaiE S <br />Balance p�e S <br />Broadway South Partners 301 Teleeranh Rd Bellineham 98226 671-2275 <br />Owner Mailing Address City Zip Phone <br />Charlie <br />Mailing <br />up <br />Describe Proposed Work ��•� � v� New ap�[met[t - 4 buildings - 18 units total <br />Prolect Add�ess (if known) <br />Attach four (4) copies of plans loi pr�posed work • Draw to scale and �ote the following as applicable: <br />• Property Lines <br />• Outline and dimf�nsions of all existing and <br />proposed structures on ihe lot <br />• Exis[ing and proposed utilities <br />• Centerline of street <br />• �ndicale North <br />• Show any proposed grading changes <br />• Show measureme�ts <br />PERMIT CONDITIONS <br />t. All calls for inspectbn she�l be made 24 hrs. in advance • phone 259•8810. <br />2. All work shell be perlormed In eccordance with this permit end cuRent City ol Everett Design and Construdion <br />Standards and Specificationa <br />3. Call Locetion Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800-424-5555. <br />� l.(1n�,� �fo .Je do.a� <br />en // -a7- 9s <br />Per �O`�nf R �J��-d ✓e d <br />!' <br />Approvetl as Constructed <br />�PUDLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />Phone:259-8810 <br />W <br />� <br />� <br />� <br />O <br />� <br />�O � <br />�` g� ��� a <br />0� ��,9 ... <br />p�\ .••''��(� <br />��'� ,..•p•���P o9n <br />ACKNOWLEDGEM,E1Nb�nF'�DiTIONS <br />The undersigned owner/applic�r�T�nr� egrees to hold and save harm- <br />less the Gity ol Everetl irom r��Alid all claims for damages, cosis, <br />expenses, or causes of action that may arise because of inslallation <br />and maintenance of the improvement or other right-of-way use hereto <br />applied for and further agrees to remove same upon notice from the <br />City and to replace public property damaged thereby. <br />� �Ebx� �- y- 96 <br />Signature ol Applicant Date <br />WORK AUTHORI2ED BY THIS PERMIT MUST BE STARTED WITHIN <br />780 DAYS OF DATE 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 THIS <br />PROJECT OVER 90 DAYS DURATION. <br />