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� ° <br />Q�� <br />�Hm <br />K�� <br />7o0 <br />^�9N71 <br />(A <br />xo <br />�MC <br />��g <br />QY (] <br />ry�� <br />� <br />N <br />Ci W <br />F� � <br />OW <br />�C <br />� �� <br />I <br />� �� <br />�-?-Zcv-S <br />Date 11 10 92 <br />AppliCation For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Pu01¢ Wo�Rs Peem9�� p� _ � �/ <br />eme. Deo�. • �p <br />PuobcWoihaiee s <br />Tolx� Fee <br />LesaO.pplFuePei� 5 <br />Bdlancc0uo S� <br />TO PQSTING 9-i-�3 <br />Leitch .7effrey 5806-1/1 3rd Ave t�� Seattle, WA 98107 526-2791 <br />Owner Mailing Address Ciry Zip Phone <br />Trigny Corp. (General Contractor) <br />qpplican� Mal�ln9 Address <br />zin <br />Describe Proposed Work Oonstruct new SFR _ <br />Prolect Address (il known) <br />Attach lour �4) copi�s M plans br proposed work - Draw to scale antl nole the lolluwing as apU��wble <br />• Prope�ty Lines • Centerline of street <br />O Outline and dimensions ol all exislinc� and • Indicate North <br />proposed struclures on the lot • Show any proposed gradinq changes <br />• Existinn and proposed utilities • Show measurements <br />PERMIT CCNDITIONS <br />1. All calls lor inspection ahall be r,iade 24 hrs. in advance - phone 259•8810. <br />2. All work shnll be oedormed in accordenre v�ith this pr,rmil and current Ciry of Everetl Design and Construction <br />Slandards anu Specilications. <br />3. Call Localiun Underpround Service 48 hrs. belore you dip. TOLL FREE NUMBER 1•800•424•5555. <br />i:��`.r,r, cy J <br />� �� -���Ll�`-' ��- ��r�`/� <br />ApPrc ��Aol ^. '� .��,��on,- � Date <br />/� / / ��'�l // <br />.�� � �i <br />��,_ _- . __�-. — <br />FINAL.:JP�['TI�'� . Datc <br />APProveo.�sCon� -.ta <br />�'7:`UC'NORKS CE.'Af �TMENT <br />�=� :200CedarSVect <br />,�s%'4�� Everott, WA 9820� <br />Phene: 259�88?G <br />ACKNOWLE�GENIENT OF CONDITIONS <br />� <br />O <br />� <br />N <br />O <br />a <br />The unuer�igm a uwn.�r/applicanl hereby agrees to hold and save harm� <br />less Ihe City �d !-.ver��tl Irom am� and all claims lor damages, cosls. <br />eapenx_ or cau:es ot action th3t ma�� arise bewuse ot installotion <br />and mam�c nnnce ol he � �•n�,ent or other righ4ol�wal use hareto <br />app�iad for anc li�rth��i/ grees remove same upon nutice hom lhe <br />City and lo rep�ncr p� 1�11�: Proper� damnyed iherehy. <br />� �� , v. � �z l,-z z <br />Sipna �.�An I�c .� �'�-�-� Dato <br />WGnK nUTHORI7.E�. 't�Y T�IIS PERidIT MUST BE :TAf7TED WIiHIN <br />160 DAVS OF CA1E �EF�GIT IS ISSUED AND 7HEREAFTER IS TO <br />BE L`ILIGENTLV oVRSUED TO COMPLETIJN. THIS PFRLIIT MAV BE <br />CANCFLLED BY T4E CiTY UPON ANY STGPPAGE OF VORK ON?'i15 <br />PR7JEGT OVER ?0 D�YS DURAfION. <br />