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<br /> 7/2/93 IO T.�G � "�' \ PubhcWaiksPermit+ —
<br /> Date a,�9 oop� = G 1200
<br /> , Application For
<br /> wp��S pERMl7 PubM1CYlorkSFea �
<br /> PU B LI C To�,�Feo �
<br /> Less AOo��Fee Paia $---�—
<br /> � Balonce Ouc S ��
<br /> Print or Type Only ,
<br /> � L-� •� ��^ � �� _ Phone .
<br /> �',1�'. ' City Zip , �
<br /> � Owner ` Mailina Address ,
<br /> fh•1neY ���Y Zip Phone
<br /> Applicant PAailing Address
<br /> i���..
<br /> Describe Proposed Work
<br /> Ivc:� i�un�te .,,..,ic 1&4
<br /> �
<br /> --�— cno / lc« P7 _ Tof ?�� Gilvarha..,1• _ � ���I
<br /> � Project Addrese(i� known) � 'I
<br /> �'� Atlach four(n)copies of plans for Proposed work� Draw lo scale and nole�CeolteWline ol streeii able: �
<br /> • Properry Lines • Indicate Norih
<br /> O Oulline and dimensions ot all existing and � � Show any proposed grading changes � I I
<br /> proposed stnictures on lhe lot � Show measuremeNs
<br /> � • Existing and proposed utilities
<br /> � GO NOT WRITE BELOW THIS LINE �j I �
<br /> 7 I I
<br /> � PERMITCONDITIONS � ,
<br /> � t.All calls(er inspection shall be made 24 h�s.in advance-phone 25n•8810. I
<br /> 2.All work shall be performed in accordance with ihis permit and wrrent City ot Everett Design and Construction �
<br /> Standards and Specifications.
<br /> � 3.Call Location Underground Service 48 hrs before you dig TOLL FREc N'UMBER 1 NB00•424•5 • I
<br /> � 4. 1n51.A11 Y'�� � i�.r'i i i � . n: t �.r -�:i'_'�. bFhP.��] i - . } tl � i _ Sd� 1'.-�� �
<br /> � )J
<br /> � standard it�t��j �,�, � ����_o�, �i�,rol as dir,,�
<br /> � Tne�cLor. I
<br /> 5. KeeF rity streeta clean at al.l times � I
<br /> g C u r b �+tter and ai.dewalk in the pl.at a'ie new :snd undamagf'�a.
<br />� Ij �y d�-�mage theret.o shall he rep lare d a t t h e d i a c c e t ion o�. ' �
<br /> I public Worka Inspector_ t.yid FY7 ' ,� �
<br /> i
<br /> 7_ Any change in thc� drivecaay cut must be dl'Proved by �
<br /> apector, wiclth at proF line lim�ted to exietin� apron �ii�� 1
<br /> 8, ��er.t all roof, yard and c�'iveway draina to storm dr ��� �
<br /> s�•stem provided to lat •
<br /> 9. �,c'.iu:tt v;�te7• I�o:ce:� t�, zrade at end oT ron�tructir�n.
<br /> .�c,�nF�]rr�� L� rvtre�l V,�>fnr,�� drivirre: ern ;i� �
<br /> 1�'_ I i .. �hal l b �
<br /> �I AGKNOW:EDGEMENT OF CONDITIONS
<br /> The undersigned owner/apPlicant hereby agrees to hold and save harm-
<br /> �1L`` 'ess ihe Gity ot Everetl trom any and all claims tor damages, wsts,
<br />� I r I expenses. or causes ol action Ihat may arise because of installation
<br /> J � � and mainiznance of the improvement or other right-of-way usa herelo
<br /> I � i� /J/ �/C� � 'lL �� /� I applied for and further agrees to remove same upon nolice from ihe
<br /> Date City and lo replace puhlic property damagetl �hereby.
<br /> � Approved for Gonstruction I , � r - �
<br /> i .,:.- ". . (� _ :—_. " .^� / :J'" i � . , � \ �� ' � ���' � � � I � "
<br /> Date
<br /> FINAL WSPECTION Date � �9nature of Applicant '
<br /> I qpproved as Gansiructed ydORK AUTHOG!ZED 0'/ THIS PERMIT MUST BE STARTED WITHIN
<br /> � PUBLIG WORKS DEPARTMENT gEODDLIGEhTL-DFURSUED TOICOMPLETIOND H S PERMIT Ml�Y BE �
<br /> 3200CedarStreet ---_---__. __.. . ._ ____ ---I I�
<br /> Ev�retl.WA 982�� CANCELLED EY THE CITY UPON ANY STOPPAGE OF WORK ON THIS
<br /> phone:259�BB10 P R O J E GT OV.=_�90 DAYS DURATION.
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