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Y APpika9on For <br />PUBLIC WORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 259-8810 <br />TYPE OR PRINT ONLY <br />Date B-20-96 <br />Public Works Permit 0 96/308 <br />Building Permit N <br />' p0 <br />Public Works Fee $-1.-20 ,� <br />STEVE NOVY 3014 23RD ST EVERETT 98201 252-0247 <br />Owner Mailing Address city Zip Phone <br />Applicant Mailing Address City Zip Phone <br />Describe Proposed Work <br />PROJECT ADDRESS (if known) <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the following if applicable: <br />'Property Lines 'Outline and dimensions of all existing and proposed structures on the lot •Existing and proposed utilities <br />'Centedine of street •Indicate North 'Show any proposed grading changes 'Show measurements <br />PERMIT CONDITIONS: <br />1. All calls for inspection shall be made 24 hours in advance - phone 259-8810. <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and <br />Construction Standards and Specifications. <br />3. Call Location Underground Service 48 his. before you dig. TOLL FREE NUMBER 1-800-424-5555. <br />4. Sanitary sewer to be a minimum of 6" diameter from building to <br />sewer main. This may require upgrade of the existing sewer. <br />5. Water service to be converted to a metered service by the City <br />water department. p <br />6. Pave parking area. <br />1L 08/21/96 8:21AN <br />e ��O N00096308 <br />DRNW $20.00 <br />'J \ DECK $M.00 <br />O _ <br />ApproM for Construction Date <br />FINAL INSPECTION <br />Approved as Constructed <br />TU <br />M <br />ca <br />0 <br />M) <br />z <br />0 <br />0 <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and am harmless <br />the City of Everett from any and all claims for damages, costs, expenses, or <br />causes of action that may arise because of installation and malaterwwe of <br />the Improvement or other right-of-way use hereto applied for and hMheragim <br />to remove same upon notice from the City and to replace public prop" �- <br />damaged thereby. <br />Slgriaure of Applicant Dale <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT Is ISSUED AND THEREAFTER IS TO§pa lGli PURSUED TO <br />COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90DURATION. <br />