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�� <br /> Applicatlon For // <br /> � PUE�LIC WORKS l�ERM6T Date 1-11-99 <br /> PU6LIC WORKS DEPAR7MENT Publis Works Permit f1 �-1 I v�3 <br /> 3200 Cedar Street ' 1 <br /> Everett,WA 98201 259-6810 eudding Permu#_ 61334 <br /> TYPE OR PRWT ONLY ��— y t�I+SOd Ol public Werks Fee 5 �iD <br /> ?des Ingrum 2312 136th P1 SW Lynnwood 98037 h25-742-8487 <br /> Owner Mailing Address City 7ip Phone <br /> Owner <br /> Applicant Maiiing Address City Zip Phone <br /> Describe Proposed Work new house � <br /> — - 1'� <br /> 0 <br /> V� <br /> PROJECT ADDRESS (if known) 1110 42nd St _ � <br /> Attach four(4)copies of plans for pmposed work-Oraw to scale and note the foilowing if applicaole: � <br /> •Property Lines •Outline and dimensions of all existing and proposed structures on tho lot •Existing and proposed utilities <br /> •Centerline of street •Indicate North •Show any proposed grading changes •Show measuremenis � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMII'CONDITIONS: � <br /> 1.All calls fcr inspection shall be made 24 hours in advance- phone 259-8810. � <br /> 2. All wo;k shall be performed in accordance with this permit and current City uf Everett �as;gn and <br /> Construction Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-80Q•424-5555. � <br /> �. Co�nec� rroof-�� rv� cF-F -b 5�de se��;' �� s<..wc✓��✓ � <br /> 5-�d �fi�,� �gal , �. <br /> a;:. <br /> , , z�. <br /> _ �,�; <br /> �1 C. 1 <br /> �_ �V. <br /> JJl"' <br /> , �A� <br /> `-T` <br /> ACKNOWLEDGEMENT Of CONDITIJNS <br /> /, �^^� The undersigned owner/applicant hereby agrees to hold and save harmless <br /> yY�� the Ciry ol Everett from any and all claims for damages,costs,expenses,or <br /> Appmved cr�on rudion Date — causes of action that may arise because of installalion and maintenance of <br /> / iheimprovemeniorotherright-o4wayuseheretoappliedforandfuM1heragrees . <br /> / . to remove same upon nolice from the City and to replace public property <br /> ���j� � ��-Ci C.•' damaged therzby. <br /> � ,L <br /> FI AL INSPECTION Dale <br /> Approved as Conshucted � J ��y�y9 <br /> Signature of Applica Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 1B0 DAl'S Of DATE PERMIT IS ISSUED AN�THEREAFTER IS TO 6E DILIGENTLY PURSUED TO <br /> CGMPLETION.THIS PERMIT MAY BE Ci+NCELLED BY Tli[CIN UPON ANY:�TOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYC DURATION. <br />