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� <br />TYPE OR PRINT ONLY <br />�'1dication For .—, <br />PUBLIC 1hJRKS PERMIT Date 1-16-96 <br />PUBLIC WORKS DEPARTMENT Public Works Pertnit N <br />3200 Cedar Sireet <br />Everen, Wq 98201 259-BB70 <br />euilding Permit p 50520 <br />Public Works Fee $ <br />6 Margo McElhaney 2719 Taylor Dr Evere[t 98203 745-3633 <br />/�VUIC]] <br />Russell Keyes 827-6188 <br />Describe Proposed Work <br />MVUIC�S <br />remodel 6 add <br />PROJECT ADDRESS (if known) 2719 <br />Attach four (4) copies o} plans tor proposed work - D�aw to scale and note the following if applicable: <br />•Property Lines 'Outline and tlimenslons of all ezisting and proposed structures on the Iot �Existing and proposed utilitles <br />'Centerline ol street •Indicate North •Show any proposed grading changes •Show measurements <br />- ---. ......--_...,.. ����.,���.� <br />PERMIT CONDITIONS: <br />1. All calls for inspection shall be made 24 hours in advance - phone 259-8810. <br />2. All work shall be periormed in accordance with this pertnit and current City of Everett Design and <br />Construction Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER t-800-424-5555, <br />aURLIC i��ORKS PEPMI' <br />3Y�h0 EOUTAE'� <br />���� - <br />MTF.. .�G.! y. _p�_._ <br />/ / <br />Approved for Consiruction Date <br />FINAL INSPECTION Date <br />Approved as Conetrvcted <br />� <br />O <br />��/� <br />V♦ <br />O <br />a <br />.1CKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save hartnless <br />the City o} Evemit from any and all claims }or damages, costs, expenses, or <br />causes of action that may arise because of installation and maintenance of <br />the Improvement or other right-of-way use hereto applied for and further agrees <br />to remove same upon notice from the City antl to replace public property <br />damaged thereby. <br />Signature o1 Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTEG WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS TO BE DILIGENTLY PURSUED TO <br />COMPLEf1pN. 7HIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANV STOPPAGE OF WORK ON THIS PROJECT OVEq 90 DAYS DURATION. <br />