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� A �y <br />� <br />>H~ <br />H�H <br />fe f] <br />H �I <br />'� H '�1 <br />C/� H <br />[Tl O � <br />O H <br />n <br />� � � <br />yH <br />t"y� <br />g H <br />n�y <br />�O� <br />I�... ,,,�! <br />\� ~` <br />L1/21/91 TO PQSTING_��� <br />Date <br />Application For <br />PU�LIC WORKS PERMI <br />. r :' <br />Print or Type Only *- <br />4 <br />€- <br />Lyle E Blank POII 2266 i:verett 98203 355 <br />ling Address ;� <br />u <br />d <br />ling Addres& <br />Describe Proposed Work New sfr <br />Prolecl Address (il known) <br />W• C�—z�-5 J� [al / <br />Public Worka Parmp t � <br />eiea ocn�. • -- <br />� Public Work9 FBe $ — <br />TelalFae <br />Less AOP�. Fea PeiE � <br />Ba�anre Duc d � I <br />� _ �; t��� �� �; — <br />O C.� ) CJ �. 1 CJ [.:, <br />�u� �,�:, <br />.� � <br />,n m �;, <br />�7�25 r- ' <br />°i r'U�tY,'l � r��ZP Phone <br />i �i�� Ci�i �� ri = u <br />...�,�.ir � ii�.. � � <br />City Zip Phone <br />Attach four (4) copies of plans tor proposed work - Draw to scale and note the lollowing as applicable: <br />• Property Lines • Cenlerline of street <br />• Outline and dimensions of all existing and • Indicate Norih <br />proposed structures on the lot O Show any proposed 9rading changes <br />• Existin9 and proposed utili�ies • Show measurements <br />PERMIT CONDITICNS <br />1. All call� for inspection shall be made 24 hrs. in advance - phone 259•8810. <br />2, AII work shell be performed in acwrdance with this permit and cu« ent Ciry of Everett Design and Construction <br />Standards and Specificaticns. <br />3. �.:all Location Underground Service 48 hrs. hetore you dig.',-OLL FREE NUMBER 1-800•424•5555. <br />��(� ,z-�-y I <br />Appro ed lor Co�st uction Date <br />�'C-���f" l-/- >'z _ <br />FINAL INSPECTION Date <br />Approved as Construcled <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Stree� <br />Evorett. WA 98201 <br />Phona:2S9�8810 <br />ACKNOWLEOGEMENT OF CONDITIONS <br />The untlersigned ownerlapplicant hereby agrees to hold and save harm- <br />less the Gry ol Everett fmm any and all claims lor damages. costs, <br />expenses, or causes ol action ihat may arise because ot installation <br />and mainlenance of the improvement or other ri�ht-ot�way use hereto <br />applied tor and further agrees to remove same upon notice Irom lhe <br />Cily and to.replace pu6lic property damaged lherehy. <br />l�% i 4�/�.:,,�%r' ��/n/� <br />V�RK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITNIN <br />1B0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />C�NCFLLED BY TIi[ CITY UPON ANY STOPPAGE OF WORK ON THIS � <br />PROJECT OVER 90 DAYS DURATION. � <br />