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I II <br /> � l� �� / <br /> � APPIicallon For <br /> PUBLIC WORKS PERMIT Date 3/18/97 ' <br /> I PUBLIC WOflKS DEPARTMENT g?—y <br /> � 3200 Cedar Street Public Works Permit q (J / <br />� Everett,WA 98201 259-8810 . <br /> OCT O s 1997 Building Pertnit# 5G 5 S 9 <br /> TYPEORPRINTONLY �Q pOSTlNG PublicWod<sFee$_� � <br /> I <br /> _L � L VENTURF 1(1717 Fvrnr Y pvFnvmT <br /> Owner MailingAddress 9A2�4 790 7Atu <br /> City Zip Phone <br /> 1�ARRv pOND 2on_iu�q <br /> Applicant Mailing Addiess <br /> ��Ty Z�P Phone <br /> Describe Proposed Work NEW HOUSE — BASIC 122 <br /> W <br /> 04/04/97 2�41PH OOONN063 �:k <br /> PROJECT ADDRESS(if known) _I�Q� L'9--� ��/ 5c-: W.1D054552 �/ <br /> r nT a ��..• PT A'R_ ���_ <br /> Attach four(4)copies of plans for proposed work-Draw to scale and rote the following if appliceble: P�B� �3,� � <br /> � •Property Lines �Outline and dimensions of all existing and proposed structures on the lot •Existing and p ed utilitie2"�'� O . <br /> 'Centeriine of street •Indicate North •Show any proposed greding changes •Show measurements��j #•� <br /> DO NOT WRITE BELOW THIS LINE ���� � <br /> PERMIT CONDITIONS: �9� • <br /> 1.All calls for inspection shall be made 24 hours in advance-phone 259-881 p. 61RTER gbp,pp � <br /> 2.All work shall be pertormed in accordance with this permit and current Ci of O <br /> � Construction Standards and Specifications. � ��asign and , <br /> , 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUM�11�'1gp�,�, <br /> y+ l��K S^c359.06 � <br /> i 1 As Jier pnblic �vorks appro��ed site plan. w♦ <br /> �. Inst111 a�� inii!traticn trench built as per Seciion 3-2.6.2 ;uu� Fiqure and Tabla 3-2.2 ofihe city O <br /> :;lo�niwator Ni��agamenl �lanual (copy'a stapied to fl�is pennit). Ti�e infilhatiou treuch shtill be n a <br /> clo:;er th�� 5 tcet to an5�up slope propeity (ine or founJafion nor closer than ]0 feet to a�iy do�vuslo e <br /> P�orPri}� line or tonndatioa Ca11 Public Wurks tor an inspection prior to coveriqg trenches. <br /> , ��!� <br /> ;�,: <br /> � ACKNOWLEDGEMENTOFCONDITIONS � <br /> � � The undersigned owner/applicant hereby agrees to hoid and save harmless <br /> the City of Everett from any and all claims for damages,costs,expenses,or <br /> Approved for Constructio p e causes of action that may arise because of installation and maintenance of <br /> the improvement or othei right-of-way use hereto applied for and further ag�ees <br /> � � i/_;/� � to remove same upon notice from the Ciry and to replace public property <br /> ��L��� 9 y s 7 damaged thereby. <br /> FINAL INSPECTION Date <br /> Approved as Constructed S . <br /> ���n' //I � <br /> . _A � ���� <br /> �/S�gnature of pplica t Date <br /> WORK AUTHORIZEC BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLt710N.THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT QVER 90 DAYS DURATION. <br />