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.lu .� .,,_.:..�,,;.,:,.:. <br />f <br />I <br />� � <br />T�'PE OR PRINT ONLY <br />Applicatbn For <br />PUBLICCJORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 259-8810 <br />o�_' 10/2/96 <br />Fubfie worka Permn N �� i0/�"Z `�J <br />Building Permtt N <br />Public Works Fee S � l <br />HEFRIRK SCOTT YO BOX 12922 AfIi.L CGEE[� 9fi0fi2 '152-2 7� <br />Owner Mailing Address City Zip Phone <br />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 tollowing if applicable: <br />•Property Lines 'Outlina and dimensions ot all existing and proposed structures on the lot •Existing and pmposed u111ities <br />`Centerline of street •Indicate North •Show any proposed grading chenges •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 hrs. before you dig. TOLL FREE NUMBER 7-800-42Mb565. <br />�• �i'O v ��c�G <br />�! ��-tcd <br />/-} o-{��_+�'��- <br />N�� 1,���b. <br />�>o�i�''I'�,'vl� �"fic1�5 s'IS �JE�� ;>I,=dr� <br />�. lJ �� �� ruc� �vzrl c r� N� ce -I � rrt c+e r cd `.e w; c c. <br />���_ i�J' �//.%��F <br />proved fo�n'stru�' n ,' De e <br />,� . <br />FINAL INSPECTION Date <br />Approved as Constructed <br />o����� <br />DEG 181gg6 <br />.................................... <br />CITY OF EVERETT <br />Bulldina Division <br />: ACKNOWLEDGEMENTOFCONDITIONS . <br />The undersigne� ownedepplicant hereby agrees to hold and save hertnless <br />the City oi Everett from any and al� claims for damages, costs, gcpenses, or <br />causes ot action that may arise because of installation and maintenance of <br />the improvement or other righhof-way use heiato appiied for and Porther aprees <br />to remove same upon not{ce from tha City and to replace public propMy <br />damaged thereby. <br />i � <br />/� �uL�� � /�/i�%- <br />Sfgnature of Applicant � Date <br />WORK AUTHORIZED BY iHIS PERMIT MUST BE STARTED WITHIN 1B0 DAYS OF OATE PERMR IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO <br />COMPLEfION. THIS PERMR MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PR0.IECT OVER 80 DAYS DURATION, <br />