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Date <br />Application For <br />PUBLIC WORKS PERMIT <br />Print or Type Oniy <br />Plan Check No: C 48712 SEPA <br />Applicat.Date: 06/26/95 <br />Job Addre: 2211 14TH ST <br />Owner: LILLEY DARWIN L <br />Owne� Tenant: <br />Proposed Uee: SINGLE FAMILY RESIDENCE <br />Deec. of Work: <br />MANUFACTURED HOME FOUNDATION & PLACEMENT <br />Applicant <br />OFFICE SET JOB SET <br />Describe Proposed Work _ APPRVD FOR PERMZT: DATE_/_/_ <br />Pralect Address (if known! <br />Pub�¢ Worws Permi� • <br />Bitlg. Depi. � <br />7ulibc Wo�xs Fqe S <br />Tolal �ee <br />Less <oui F?e Pri� $ <br />palanceCuc $_ <br />'iF Phonr. <br />!ip Phone <br />Attach four �4) copies ot plans tor pmposed wu�k � Draw. tn sr,ai� a❑n ncte [he'o�lowing as apU�ica6le: <br />• Property Lines • Centerline nf streel <br />• Outline and dimensions of all existing antl • Indicah� Norih <br />proposed slructures on the lot • 9now any croposed gradin9 changes <br />• Exis�ing and proposed utililies • Show measurements <br />LIN <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hrs. in advance • phone 259•8810. <br />2. All work shall be pedormed in accordance with this permit and wrrent City of Everett Design and Construction <br />Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. betore you dig. TOLL FREE NUMBER 1-800•424-5555. <br />� � �y/M � � �UO � .C�'!✓/�� <br />/ � l/ <br />I � �� ia����- <br />, ��s� <br />� _�e�-,� � ��f��� �; � ,��--��l�-d <br />Approved tor ConsiruCtion <br />Qdi2 <br />FINAL INSPECTION Date <br />Approved as Constructed <br />�A�I�(/ PUBIIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />Phone:259-8810 <br />� <br />� <br />� <br />� <br />� <br />a <br />ACKNOWLEDGEPAEN7 OF CONDITIONS <br />The under�ianed owneUapplicxnt hereby agrees to hold and sae�e harm� <br />less ;ha Gly ol Everett from any and all claims for damaqes. costs. <br />expenses. o� causes of action that may arise because of ins�allation <br />and maintenanCe o! lhe improvement or o�her righ�•of•way use hereto <br />appl�ed lor and further agrees lo remove same upon notiCe trom the <br />C�;y snd to replaca public properry damaged thereby. <br />Signature ol Applican! Date <br />WORK AU7HORIZED 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 STOPPAGE OF WORK ON THIS <br />PRO.IECT OVER 90 DAYS DURATION. <br />