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Date_ 11/2/92 <br />s�r .sa9 <br />Applkatlon For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Bruce Moser <br />Owner <br />15818 Old Snohomish Rd <br />MaiNng Atldress <br />v�e�Kwon.r•.mn. 93 �a9 <br />BMp. D�OL � _ <br />N�ei¢ work. F« <br />Tol�l Fae� f <br />Lau Aoo� Fse PaiE i <br />Bal�nc� Ou� � �S� <br />Op2- 3zzyo � 7a3i <br />Snohomieh WA 9829G (206) 481-1300 <br />City <br />Phone <br />Same <br />Applicent Mailing Address City Zip Phone <br />Describe Proposed Work <br />��[�mvv� cw�cn.�fY ru6�IP �ra..� si�e G�il�f Mac�i.n���/ qnd <br />Prolect Address (if known) <br />Atlach four (4) copie,s ol plans tor proposed work - Draw to scale and note the following as apDlicable: <br />• Property Lines • Centerline ol sireet <br />• Outline and dimensions o� ell existing and • Indicate North <br />proposed structures on the lot • Show any proposed gratling changes <br />• Existing and proposed utilities � Show measurements <br />PERMIT CONDITIONS <br />1. All calls for Inapecibn shell be mede 24 hrs in edvance • phone 259$810. <br />2. All work ahell be peAormed in eccordance with ihis permfl and cu�ent City ol Everett Deaign end Conetructlon <br />Slandarda end Specificationa <br />3. Call Location Underground Service 4B hrs. before you dig. TOLL FREE NUMBER 1•800-4245555. <br />� 4�,� �Lfarr CL�or�� oi- 9r#J.:,� of' f/�c S.t`� <br />.S'/MLL �"i��/i�'t /,✓c.rfLan� 2raotl �P O�eLin«fe�, <br />S Lon�ot7� S�v�r .i�isnLsy C.//�� f�je C/{��J(ann�n9 �Pf <br />L,y�'is rry<..a/s �a �v99�".9 rtlo.,y �fc /�orf/, s,d� 6}C' <br />•�/re Cor+crefe de6r;s, <br />i <br />c <br />- ������- 3/��9j <br />Approved orConsiruction ",n � Date <br />�%,.{�..�n- <br />l��o �c��ac�. �AJo i�m�-c,(�un ,,��v �� � 99 <br />FINAL INSPE TION De�2 <br />Approved as Constructed <br />�PUBIIC WORKS DEPARTMENT <br />3200 Ceder Stroet <br />n Everett WA 98201 <br />Phone: 258�8B1G <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />H <br />� <br />� <br />0 <br />� <br />� <br />O <br />a <br />The undersigned owner/applicunt hereby agrees to hold and save harm• <br />less the City ol Everett Irom any and all cleima lor demepes, costs, <br />expenses, or causes ot ection that may erise because of installatlon <br />and maintenence of the improvement or other righl•of•way use hereto <br />applied for and further egrees to remove same upon notice irom the <br />Cily and to replace public Droperty dameged theroby. <br />Signatu�e of AppliEant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAVS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PEFMIT MAY BE <br />CANCELIED 8Y THE CITY UPON ANY STOPPA6E OF WORK ON THIS <br />PROJECT OVER 90 DAYS DUHATION. <br />