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8-12-99 <br />i <br />Application: For <br />PUBLIC WORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 (425) 257-8810 <br />VOTING FEB <br />TYPE OR PRINT ONLY <br />Date <br />Public Works Permit # qa <br />Building Permit rf C9908-002 <br />Public Works Fee $ 90 <br />North Crest Dev PO Box 340 Edmonds 98020 425 774-3181 <br />Owner Mailing Address City Zip Phone <br />Owner <br />Applicant Mailing Address City Zip Phone r� <br />Describe Pr000sed Work new <br />PROJECT ADDRESS (if known) <br />LAIR 21st Dr SW <br />Lot 11 Bush Gardena <br />Attach four (4) copies plans for proposed work - Draw to scale and note the following if applicable: <br />• Property Lines • Outline and dimensions of all existing and proposed structures on the lot • Existing and proposed utilities <br />• renterline of street • Indicate North • Show any proposed grading changes • Show measurements <br />DO NOT WRITE BELOW THIS LINE <br />PERMIT CONDITIONS: <br />1. All ca!ls for inspection shall be made 24 hours in advance - phone (425) 257-8810 <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 1-800-424-5555. <br />41 <br />Cc3wne�� 1�0f p rwn F' `60 <br />fi q& 2 <br />pprove or ns r pn a e <br />li <br />S <br />FINAL INS ECTION Date <br />Approved as Constructed <br />SlW 4.1 c)rk '�, J4 12. <br />P1 <br />in <br />0 <br />MWJ <br />0 <br />0 <br />0 <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />Tte undersigned owner/applicant hereby agrees to hold and save harmless <br />the City of Everett from any and all claims for damages, costs, expenses, or <br />causes of action that may adse because of installation and maintenance of the <br />improvement or other right-of-way use hereto applied for and further agrees to <br />remove same <br />'/�upon notice from the City and to replace public property dam- <br />aged h\rv'` % 1-;I qp <br />1 <br />8igna ure o <br />gLIO n Y PURSUED TO <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE <br />COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />