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Date 3/19/86 <br />Application For <br />PUBLIC WORifS PERSVIIT <br />Print or Type Only <br />Pu�lic Worhs Permil rt Cl( 1—/�/ _ <br />Biae.Deo�.+ 86/16265 <br />Puo'ic Warks Fe•• <br />Total Fee � <br />Less aoPl. Fee Paid $ <br />ealance oue S ZQ ��d <br />Lessley Consiruction 18204 Bothell-�erett Hwp #2 Bothell 9P012 481-8866 <br />Owner Mailing Address Cit <br />Y 2iP Phqne <br />Same <br />Applicant <br />Mailing Address <br />Cily Zip phone <br />Describe P�oposed Work Conaf,r ,�r nPu, c: nyl a fam; i y h�ma <br />Bacir lOQ6 Tnt 97 W'lln� (Ya k f•7 <br />Prolect Address (if known� 1526 — Slst Pl SW <br />Attach four (J) copies of plans lor proposed work - Draw to scale and note the following as applicable: <br />• Property Lines <br />• Outline and dimensions of all existing and <br />proposed strucWres on the lot <br />• Existing and proposed utilities <br />PERMIT CONDITIONS <br />• Ceoterline ot stree; <br />• In�i!cate Norlh <br />• Show any proposed grading chnnges <br />• Show measurements <br />1. All calls for inspection shall be made 24 hrs in advance - phone 259•881 5. <br />2. All work shall be performed in accordance with ihis F=rmit and current City of Everett Design and Cons!.uctio.-� <br />StanAards and Specifications. <br />3. Call Location Underground Service 48 hrs. belore you dig. TOLL FREE NUMBER 1•800•424•5555. <br />Approved for Conctr�fction �� Ds e <br />` � i�-�,�- <br />FIN9y1N E@T N Dale <br />Ap�roved as Constructed <br />evereti PUBLIC W�RKS DEPAHTMENT <br />� 3200 Cedar Street <br />Everett, WA 98207 <br />Phone: 259•8815 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />� <br />� <br />� <br />� <br />� <br />The undersigned owner/applicant hereby agrees to hold and save harm• <br />less the City of Everett irom any and all claims for damages, costs, <br />expenses, or causes of action that may arise because of instaifation <br />and maintenance of the improvement or other right-of-way use hereto <br />applied for and rurther agrees to remove same upon notice from ihe <br />City and to replace pi�blic pioperry damaged thereby. <br />Signature of Applicant � Date <br />WORK AUTHORI2ED EY THIS PERMIT MUST BE STARTED WITHIN <br />190 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. ThIIS PERMI7 MAY BE <br />CANCELLED BY THE CITY UPON ANY STCPPAGE OF WORK ON THIu <br />PROJECT OVER 90 DAYS DURATION. <br />