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POSTING PT 16 1999 <br />Application For .� <br />PUBLIC WORKS PERMIT Do <br />Q <br />O <br />Print or Type Only <br />to <br />0 <br />r, no %, <br />Applicant Mailmq Address <br />City <br />,o -,ard rr <br />W M <br />W <br />S <br />r� <br />Public Works Perm" • �/ LG' / <br />Bldg Dept v _ <br />PUM¢ Works Fee <br />Total Fee S — <br />Less Apoi Fee Pa., S <br />8a1an,e puc s lob 00 <br />002 - 322r1 o/r3'B31 <br />Eradrti` <br />LO uu <br />Zen Phnnn <br />yy}j= <br />Phone <br />Describe Proposed Work -fINrty--erj1A0EinJf-._ <br />Imp"ye usp 4 <br />Project Address fit known) —4,ZL_ %�b Ave- -SG <br />Attach four (4) copies of plans lot proposed work - Draw to acalr! .Ind note the following as applicable: <br />• Property Lines • Centerline of street <br />• Outline and dimensions of all existing and • Indicate North <br />proposed structures on the lot • Show any proposed grading changr, <br />• Existing and proposed utilities • Show measurements <br />W <br />M <br />O <br />n <br />z <br />O <br />Ch <br />01 <br />G e t Sifa LP '�c 7�'Ave. f1i,-o °\ a <br />7%e L' i�'Gres 1lc%zr�y zef /1/0?" o -?. If%✓e, v <br />r 1 r.4" 4hlq, a.74 a ¢aY Poaot �v ;6;.,d n07 161 <br />CXG ea(j, /S O''4,W 'V�1,Zr>qG �h4 0'� n9 . ACKNOWLEDGEMENT OF CONDITIONS <br />The undersiqned owner/applicant hereby agrees to hold and save harm- <br />-I less the City of Everett from any and all claims for damages. costs. <br />i expenses. or causes of action that may arise because of installation <br />2_ 1 and maintenance of the improvement or other right-of-way use hereto <br />Approved for Constr on apPhed for and further agrees to remove same upon notice from the <br />afCdv and to replace public property damaged thereby. <br />&dcl Gam... <br />FINAL INSPECTION Date <br />Approved as Constructod <br />PUBLIC WORKS DEPARTMENT <br />19L 3200 Cedar Street <br />Everett, WA 98201 <br />Phone: 259-8810 <br />PERMIT CONDITIONS <br />1. All calla for inspection shall be made 24 hrs. in advance • phone 259.881 O. <br />2. All wn,IK shall be Performed in accordance with this permit and current City of Everett Design and Construction <br />Standards and Specifications. nl <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER d -ROO.424-5555. `� <br />7�JJ„�.c,/ �$�;yr. <br />7'IZ <br />i�1 Pr=r C!{y .i/Rn pin r--p/ 1 ZOS,%a .c1{ J. ' Lur <br />to -A Ze 01.r ,tit. �ifa tn.� PH � v <br />•7. /ii0_ �-uC .Cn .2`0 �G �� Ort- .F�w .�' C'�19r/C', k�� <br />'Signature of Applicant ET 'le — <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 STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION, <br />