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� / <br /> � APPlication For 4-29-�$ <br /> PUBLIC WO��KS PERMIT D81e <br /> PUBLIC WORKS DEPARTMENT Public Works Pertnit k _�VI� � <br /> 3200 Cedar Street ��T <br /> Everett,WA 98201 259-8810 Bullding Pertntt M �664 _ <br /> Tn POSTING 2 � roe <br /> TYPE OR PRINT ONLY 2 � �t � o � ��Iig,Wgk,s.�@gR_r.,�. <br /> Q�OP- 00070 (T OPO OC'J CJ <br /> 00�O . �O • � OJ <br /> romooNo � orno .-io -n �o �n <br /> Welch's Construction 6322 76th Dr SE Snohi6fdi'� ¢JSP90 °'937�52� r°.� � Q <br /> Owner Mailing Address CiN Zip � oneQ <br /> P >- <br /> 1 c� F- 1 <br /> QWR2L � t�J cE S S �.� W � ~1 � <br /> Applicant Mailing Address C :� � w �r_ ¢ w � one <br /> oa ui ii � Cn ' -"'...' =S -:'' Cn 7E" <br /> Describe Proposed Work new house - Basic ]230 � <br /> � <br /> � <br /> � <br /> PROJECTADDRESS(ifknown) 1522 49th Pl SW Lot 6 SP Ifl-97 � <br /> Attach tour(4)copies of plans 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 lot •Existing and proposed utilities <br /> •Centerline of street •Indicate North •Show any proposed grading changes •Sho•,v 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 performed in accordance with this permit and curcent 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 /> i b-�rz�� rii}' <trr�t�; clran al all iimc: � <br /> . i.Ill�l �'llll:l :IIII� tiII�CWif�{� III I�IC �)�Jl �II�C IICW �Ill(� 1U11�;1111:1k��, fl[fy (I8I118};C (IICfCIU gI1:fII �C I�C�)IifCC� fll QI O <br /> disciclinn nf Ih: }qihlic R'orks fn,pr.cior. � <br /> �� Adjusi w;dci hoxrs lo ;�radc a� rnd of conzltuclion. <br /> Iinv�•K�:n�� shall be completcl}• cnred hrfnre diivim�, on Ihr.m <br /> �. P.uollop di;iiva!�� :h,dl be JischillvCfl IG IIIIIIIIalio�i ireuches tlti �ICI"IIIC COIISIIliI'II011 (If8W1(1,85 UI IIIC Shoi1 <br /> �1�8( <br /> i. Adhc:n to lli� city's small p:ucel be�i mauaeeme-nl practices a� slnled in sc:ctiou 2-2.2 o£the. <br /> cilr I?e�ie�� :md l'onsin�ction Stsmd�rds :md Specitications for I?evelopmenl (attached). <br /> �� <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harmless <br /> � ]il A C.l�„ �/C--/Cl� the City of Everett from any and all claims for damages,costs,expenses,or <br /> G'I/� fL.(�1C. J causes of action that may arise because of installation and maintenance of <br /> rovedforCgastruction Dat theim rovementorotherri M-o}•w usehereto g <br /> i' P 9 aY aPdiedforandfurtl�era rees <br /> ./ � to remove same upon notice from the City and to repixe public property <br /> r1� ' �� JC= ��'� aged thereby. <br /> �/�—�_�—��----�. <br /> FINAL INSPECTION Date l� � � <br /> Approved as Constructed W �,0 , A_ . � � � <br /> cMx./tv <br /> Signature of Applican ate <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STAflTEO WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLEfION.THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PR0.IECT OVER 90 DAYS DURATION. <br />