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� <br /> �-�, m <br /> �iC� PUBLIC WOR�KS PERMIT � <br /> ate �/Z8�9� <br /> ���.. <br /> PUBLIC WORKS DEPARTMENT YAubl�Works Permft M 5�— — <br /> ;iy2y0p0 gCge�dar Street �p � W <br /> E�Op(��'���259..�` �' t �uild(ngPertni1N�6052 <br /> 1 V.7� V <br /> TYPE OR PRINT ONLY puslic Works Fee S <br /> �o '�.,i88iFio � � 8r�4i8 8m � <br /> GELLERSON CONSTRUCTION •��I��2 �2TID�A�E � � � <br /> Owner MallingAdd� � � _C�h, �N�8223 435-P90 e <br /> � s� s� � �- ,, Ch�•s i„o6.� 35G-77/L <br /> � .� .. $ � � � <br /> M <br /> Applicant Mailing Ad�ess= � ''' g ity � o Zip Phone <br /> oa � � � � � �� � s � <br /> Describe Propased Work NEW HOUSE . _ ■ <br /> W <br /> _ � <br /> �4� � - V� <br /> PROJECT ADDRESS(if known) _ - 48TH ST SW LOT 2 SHORT PLAT 46-96 � <br /> Attach four(4)copies of pians for proposed work-Draw to scale and note the following if applicable: O <br /> •Property Lines 'Outline and dimensions of all existing and proposed structures on the Iot •6cisting and proposed utilities <br /> •Centerline of street •Indicate NoAh •Show any proposed gradinu changes •Show measurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS: � <br /> 1.All calls for inspection shall be made 24 hours in advance- phone 259-8810. O <br /> 2. All work shall be pertormed in accordance with this permit 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 1-800-424-5555. � <br /> `� S�� StuJer Z'�o f_�e /ns��e o� �Gr Cr�7� S{�noa.�+cr � <br /> �`��/ �002 � (00¢ O <br /> S �erz� C!r{� 57��e1`r C�ean a7� aCC �...��s li <br /> (P. �Q �Z�" f�t G�/�Mcns� ` O /�'1a.�"C tiC� Oi7 /s741n <br /> .� IHSI�!�� .S'6YVl�`y 1' {�c/� r <br /> 7. Tr�s�4LL � p,.�rr�.r.� y�¢d�c�„s valvr �� �%r 6rouris <br /> Gr/ctZ�E�' S•v�olY Lirle. <br /> �_4, Zi;S��L� jn{(�.-.< �a�� ,S5/S¢e i-„ ��r Cc'�i SfF.f�a�a r�S <br /> 4'S Lcc4 �ea/ � S,��J oh /�l�f PC��� <br /> � <br /> ACKNOWLEDGEMENT OF CONDfT10NS <br /> /%„i>� /; � ���� The undersigned ownedapplicant hereby agrees to hold and save harmless <br /> �L i<f G�e�� /(�, the City of Everett trom any and ai�claims for damages,costs,expenses,or <br /> � causes of action that may arise because of installation and maintenance of <br /> Approved fof�onstruction - -� Data <br /> � / iheimprovementorotherright-of-wayuseheretoappliediorandfurtheragrees <br /> C� � to remove same upon notice from the City and to replace public property <br /> �.�l %=k�G /� -�/ j 7 damaged ihereby. <br /> FINAL INSPECTION Date / `71� <br /> Approved as Constructed {� �y Q <br /> -c �'�d ^(7 <br /> Signature of Applicant Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLETION.THIS PERMIT MAY BE CANCELLED BY THE CITV UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />