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Date1�/,� 6 <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Public Welke Permll + �6 - /39 <br />Bldg. Dept <br />Public WCrks Fee <br />Total Fee $ — <br />Less Adel. Fee Paid $ <br />Balance Due $� <br />Newton, Newton P.O. Box 79 Everett, WA 98206 (206) 259-5106 <br />Owner Mailing Address City Zip Phone <br />Newland Construction Co., Inc. P.O. Box 958 Everett, IVA 98206 (206) 259-9191 <br />�Iicant Mailing Address City Zip Phone <br />Describe Proposed Work Rough grading and mass excavation for proposed office addition <br />Project Address (if known) <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the following as applicable <br />• Property Lines <br />• Centerline of street <br />• Outline and dimensions of all existing and <br />• Indicate North <br />proposed structures on the lot <br />• Show any proposed grading changes <br />• Existing and proposed utilities <br />• Show measurements <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hrs, in advance - phone 259-8815. <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and Construction <br />Standards and Specifications. <br />3. Call Ldcerc.n I Inderground Service 48 hrs. before you dig. TOLL FREE NUMBER 1.800.424.5555. <br />10/21/66 1:39FH 001 <br />.9iUy .S/OFG/f�.'•� 1�i9//J�G�L� .�U2/iflc:r E„OcA'`��f_,'7iOni <br />,S- %�iC''C�L%!]E y�c• NEfEStyc.•j.� �z•Osip.c/ CASH $25.00 <br />�— <br />�s <br />6- ST/zEETr 1�vsT BE CLer/q'u fT .9ce- <br />`->7 emu✓ � - <br />A <br />.ppioved for <br />StI�CiL INSPECTION <br />Da c <br />Approved as Cons Ducted <br />PUBLIC WORKS DEPARTMENT <br />]ell <br />3200 Cedar Street <br />Everett, WA 98201 <br />Phone: 259.8815 <br />W <br />H <br />i <br />is <br />a <br />z <br />0 <br />�/21/86 i:2. 000AN25LI k:t:t:% W <br />ACKNOWLEDOAM CONDITIONS <br />The undersigned owner/applicRE eby;n g00hold and save harm- <br />less the City of Everett from(71nd all, for damages, costs, <br />expenses, or causes of action t armay arise because of installation <br />and maintenance of the improvement or other right-of-way use hereto <br />applied for and further agrees to remove same upon notice from the <br />City and to replace public property damaged thereby. <br />i <br />Si§nature of Applicant Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STODPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />