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Date 3/19/86 <br />Application For - �` <br />PUBLIC WORKS PERMIT <br />Print or T,�pe Only <br />�= — �s� <br />Public Wo�Ms Permil s � <br />eme� e�a.. 86/16266 <br />Pu01ic'h.,�ts <br />,�,�e� Faa <br />�ess Aoo: ree Pa�a S 2�- <br />Balt,nce Due S <br />Lessley Construction, Inc. 18204 Bothell—£verett Hwy #2 Bothell. 98012 481-8866 <br />Address <br />City Zip Phone <br />Same <br />Applicant Mailing Address City Zip Phone <br />Describe Proposed Work Wnstruction of new single family home _ <br />Basic 1096 Lot 23 Wiilow Creek Glen <br />1530 — Slst P1 SW <br />Project Address (it known) <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the following as :ipolicable: <br />• Property Lines <br />• Outline and dimensions of all existing and <br />proposed struchires on the Iet <br />• Exist�ng and proposed utilities � <br />• Centeiline of src:et <br />• Indicate NorU+ <br />• Show any proposed grading changes <br />• Show measurements <br />PERMIT GONDITIONS <br />1. All calls for inspection shall be m2de 24 hrs. in advance - phone 25�•881 5. <br />2. All work shall be performed in accerdance with ihis permit and current City ot Everett Design and Construction <br />Standards and Specific�tions - <br />3. Call Location Underground Se�vic=48 hrs. before you dig. TOLL FREE MUMBER 1-800•424-5555. <br />��C/ � ,��7C- .c-` J'�s� <br />Approved lor Construclion Dat <br />�� ���2�-3 -i�J <br />FlNAL I PECTION � Date <br />Approved as Constructed <br />everett PUBLIC WOP,KS DEPARTMENT <br />� 3200 Cedar Sireet <br />Everett. WA 98201 <br />Phone:259-8875 <br />NCKNOWLEDGHNiENT OF CONDITIONS <br />� <br />O <br />� <br />� <br />O <br />a <br />The undersigned owner/applicant hereby agrees to hold and save harm• <br />less ihe City of Everett from any and all claims tor damages, cosis, <br />expenses, or causes of actior. that may arise because of installation <br />and maintenance of the improvement or other right•of-way use herato <br />applied for and furiher agrees to remove same upnn notice from the <br />City and to replace public property damaged thereby. <br />�`--"" <br />ignature of Applicant D te <br />WORK AUTH�RiZED BY 7HIS PERInIT MUST BE STARTED WITHIV <br />180 DAYS CF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MNY BE <br />CANCELLED BY THE i,ITV UPON AhY STOPPAGE OF WORK ON THIS <br />PROJcCT OVrR 90 CI1YS DURATION. <br />