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� APPlication For — i <br /> i� <br /> P�1�LIC WORKS PERMIT Date 7-3-96 <br /> PUBLIC WORKS DEPARTMENT Public Works Permit k 7I <br /> 3200 Cedar Street <br /> Everetl,WA 98201 259-8810 Building Permit R 52196 <br /> ocr 2 s �e p <br /> TYPE OR PRINT ONLY TO POSTI N G P�n;ic Works Fee£�S�BG ¢ <br /> Snohomish County 3000 Rockefeller Ave Everett 98201 388-3718 <br /> Ovrner Mailing Address City Zip Phone <br /> Denny Youth Center Contact: Rick Reininger 388-3718 <br /> Applicant Mailing Address Cily Zip Phone <br /> Describe Proposed Work new facility � <br /> /r!� /O�S i�s-/,-�c� Crir r � >wa T L � <br /> � �� <br /> �2 ���/cr �na.r� �' S�oriy, sys�`r_�Lv.r a�Yer h-��sc Sl�e c��✓e Co �n ♦/� <br /> \/� <br /> PROJECTADDRESS(ifknown) 2801 lOth St � <br /> Attach four(4)copies of plans for proposed work-Draw to scale and no!e the following if applicable: O <br /> •Property Lines •Outline and dimensions of all existing and proposed structures on ihe lot •Euisting and proposed utilities <br /> •Centerline of street •Indicate North •Show any proposed grading changes •Show measuremenis � <br /> DO NOT WRITE BELOW THIS LINE <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 Speci(ications. <br /> 3. Cali Location Underground Sen�ice 48 lirs. before you dig. TOLL FREE NUMBER 1-800-424-5555. ` <br /> 1— <br /> � CiUiL �uor,E -�0 6e 00�'+E ��r ��G��S � <br /> �n��d 7_��_/G 6 �ic EverC�T <br /> y � ' u6��G OB/22/96 4:57FM OOOAN73 G'�:"' <br /> ��oh,Fs dZ t, p � <br /> a <br /> � �oo�b��� <br /> 5 /�'� Cr2�- .Secvc�^ t / �4'���5 OTNER f488.50 <br /> � / fo p2 oone ,y�-, PW/�EV 3481.,,9 i, <br /> � � P PLN CH i'C09.95 <br /> CZ�/qcli2d S,�¢�Clj, PLN CH V�009.95 <br /> PW/DJS S'009..95 <br /> CNEC}; �3980.04 <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> ` /� The undersigned ownedapplicant hereby agrees to hold and save harmless <br /> � Ihe City of Everett from any and all claims for damages,costs.expenses,or <br /> Approved f �nst t Dat causes of action that may arise because of installation and maintenance of <br /> P j �heimprovemeniorotherrighbof-wayuseheretoappliedforandfurtheragrees <br /> /� (! J to remove same upon notice from the City and to replace public property <br /> _�1 ` �i� /�. � a�2.��10� damaged ihereb . <br /> fINAL INSPECTION Uate <br /> Approved as Constructed � � ` <br /> 8 � <br /> S' nature {,4pplicant�ss....� �� ate <br /> �N�� <br /> ri'o � <br /> WOflK AUTHORIZED BY THIS PERMIT MUST BE STAATED K�IiHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFfER IS�O B DILIGENILY PURSUED TO <br /> COMPLETION.THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPP.GE OP WORK ON THIS PROJECT OVER 90 JAYS DURATION. � <br />