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Date_ <br />(� <br />Appl{catlon For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Owner <br />qppliCent <br />Oescribe Proposed Work _ <br />Prolect Address (il known) <br />Plan Check No: C 41652 SEPA <br />Applicat.Date: 08/11/93 <br />Job Addreee: 610 34TH ST <br />Owner: HARROWER ROHERT <br />Tenant: <br />Propoeed Uee: SINGLE FAMILY RESIDENCE <br />Deec. of Work: <br />REMODEL ADD DORMER <br />swo o.w • <br />�e� W�. F« s <br />TOWIFM <br />Lw AOM Fw G�IG { <br />Mbnu Dw i <br />p Phone <br />OFFICE SET JOB SET P <br />APPROVED FOR PERMIT: DATE_/_/_ BY <br />. <br />Adach f�ur (4) coD�es of plans for proposed work • Draw to scale and note ihe following as applicable: <br />• PropeRy Lines • Centerline of slreat <br />• Outline and dlmensions ot all existing and • Indicate North <br />propesed structures on ths lot • Show any proposed grading changes <br />• Existing and proposed uttlitiea • Show meesurements <br />Phone <br />PERMIT CONDITIONS <br />1. All calls (or inspedion ahall be mede 24 hra in advence - phone 259�8810. <br />2. FJI work shell be pertormed in accurdance with this permit and cunent City of Everett Desiqn end Construction <br />Standarda end Specificationa <br />3. Call Lxalion Underqround Service 48 hra before you dig TOLL FREE NUMBER 1•80a4245555. <br />PUBLIC WORKS PER1111T <br />NOT AE�UIREO <br />PY � <br />OATE �' �� 93 <br />Approved tor Construction Date <br />FINAL INSPECTION Dete <br />Approved as Constructed <br />�PUBIICWORKSDEP� .MENT <br />3200 Cedar Street <br />Everett WA 98201 <br />Phone: 25&8810 <br />ACKNOWLEDGEMENT OF CONOITIONS <br />W <br />� <br />� <br />� <br />� <br />� <br />O <br />a <br />7he undereigned ownedepplicant hereby egreea to hold end eave harm- <br />lesa !he Ci4y of Everett lram any and all claims for demaqea coat4 <br />ezpenaea �r causes of action that may. arise beca�se of inatellellon <br />and melntenance of the ImDrovement or other riyhPot-way we haroto <br />applied for und further apreea to remrne seme upon notice from the <br />City and to replacs public Droperty damayed therehy. <br />Siqna�u�e ot Applipnl Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT 1$ tS3UED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMQLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANV STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />