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� � 199b <br />Date 9 29 9� �(! POSTING �� ---- <br />Application For <br />PUBLlC WORKS PERNIIT <br />Print or Type Only <br />Puul�r \Yo�As on�mn • �� �_� <br />6i�q Dept • 49622 <br />Fee <br />Total Fre � <br />�u5540t�1 F?ePaip 5 � <br />oaiao�.. c,�� 5 �� O <br />:� <br />Walker Brent 6413 Berkshire Dr Everett 98203 239-8393 <br />OWOei �^,auinc� a1Cd��SS QI)' 7iP Phnni} � <br />$8ID0 <br />M.�ilinq �ltltlre'S <br />Crt�• <br />Describe Proposed work __ New dup.leX = Basic 1118 .__ <br />Phone <br />Proiect Addressl�t knowN 6225 Spting St______ _ Lot 4 q0004q6z2 <br />ELDG f1116.50 <br />A��ach four (4) coPies ol Plans loi ProPoSed wor:: � ��ar: tn ,c�ii:, an1 note the foqu�vmg as aPUlir.abie: �.�i f154.� <br />• Property LineS • Ciante�line af slreei �� s1L�.� <br />• Outline and dimensions ol all eaistmg an�1 • Ic�fical�_ Norlh C�p(; s6.SD <br />r� oposed slructures on Ihe lo� • Shoa� , ny r.roaoSeA �radii�Cmittues <br />• EsiSt�ng and proposed u�ilities •;how measurements _�:V St�.O.� <br />PERMITCONDITIONS �T� :�•� <br />1. All cal�s for inspection shall be made 24 hrs. in advance • phone 259•8810. b����� <br />2. All work shall be pedormed in accordance with this permit and current City ol Everett Desig��onstr��.UO <br />Standards and Spectications. SISOEV 51864.00 <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800-�655�461.49 <br />V' <br />c D <br />qpproved lor Con uclwn _� �=�+� <br />i / <br />���'� .r 1 ��' ` � . �/ ��` <br />FINAL INSPECTION Date <br />Approved as Constructed <br />�A�'�;� PUBLIC WORKS DEPARTMENT <br />�! 3200 Cedar Streel <br />;g Everett,WA98201 <br />Phone:259�881U <br />AGKNOWLEDG[PdENT OF CONDITIONS <br />� <br />O <br />�l ♦' <br />I•1 <br />LJ <br />Thr untleivpnetl owner/applicant horeby agrees to hold antl sove harm� <br />iess the City o� E�erelt Irom any ana an claims lor damages. costs <br />e*penses. or causes of action ihat may anse because ol inslallation <br />anA mamlrnanr.e nf Ine unprovement or other nghl�of-way use heretn <br />appnr�i for and luriher agrees to iemove same upon notice ��om Ihe <br />G;y i��d to ropL�ca nublic propertY �amageA there6y. <br />�__._t �',u1..r�--=_ /O-l6-�i� <br />Siynatwe of AnP��ean! ��<< <br />lh'ORK �1UTHORIZED BY THIS PEPG�IT PdUST 8E STARTED WITHIN <br />190 DAYS OF DATE PEFMIT IS ISSUED AND THEREAfTER IS TO <br />BE DILIGENTU' PURSUED TO COMPLETION. THIS PERMIT IdAY BE <br />CANC[LLED BY THE CITY UPON ANV STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />