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� <br />TYPE OR PRINT ONLY <br />Applicaiion For <br />PUBL IC WORKS PERMIi <br />�'UBLIC WORKS DEPARTMENT <br />3200 Cedar Slreet <br />E derett, WA 987]1 259-8810 <br />1' ���TING _ AUG 0 4 1997 <br />- s <br />Date 1-23-47 <br />Public Works Permit # _ � �/`� J <br />euilding Permit # _ 54029 <br />� <br />Public Works Fee $ <br />Kay/James Matteson 15418 29th Ave SE Mill Creek WA 98012 316-8361 <br />Owner Mailing Address City Zip Phor e <br />Ocnter <br />Applicant Mailing Address City Zip Phone <br />'-') 9' . =-� _ � <br />Describe Prcposed Work <br />_'•5 a6E,?.C_ <br />.-:_ '°;'.n �. <br />PROJECT ADDRESS (if known) ��3 1% ��! %%^ SL Lot 1 SP ll��y }+ %�''"�� <br />Attach four (4) copies of plans for pmposed work - Draw to scale and note ihe following if applicable: _� '_�, _,- _-� _ <br />•Property Lines •Outline and dimensions of all existing and proposed structures on ihe loi •Existing and propos9d"utllit(es � <br />'Centedine of slreet •Indicate Worth •Show any oroposed grading .;nanges •Show measurements �-��. `=':: �: �� -� -. <br />,r�.� ��:. - <br />DO NOT WRITE BELOW THIS LINE - .:� -� -, <br />PERMITCONDiTIONS: ;__: :,-;� --. <br />1. All calls for inspection shall be n.ade 24 hours in advance - phone 259-8810, l <br />2. All work shall be perfo� ined 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 />I (;cep cily shccis clrnn at ;i1i limc�. <br />i:mb gulter ;a�d ,id�ccalk in Ihe pl�t ate nr�v ;md unr!anu���cd_ ariy �I,miaE-,c rh;roto slr;ll I��e r.•pl;ic�d ;�t <br />discrelion of ih;: Public �t'orks Io;p�cior. <br />�, Atry ch;mt�i in Ihr drivtµ:i}' cut �i�ii<I b� �pprnved by tlic F'Vv' L�spector. wid�h at prop fine Gmit�d tn <br />c�asting �pron width. <br />Adiust watcr boxcs to !�r�dc at end of'consm�ctimi. <br />i;. Dn�cways shall 6e. cornplci�;lt' cw��d bcfor� drivize� on fhcni. <br />��. �:Oi)�IG�) (�f;�1:18�':' ��10�� �l.' ill;�:�l;i!"i[� 10 Ill; SI4IlIl (i��1118:'�' `'hlfi <br />.. ���C:Ilrfi fli I�IC �TGili ui (fli �nf <br />7 <br />.�� � ¢-zs-4'� <br />FINAL INSPECTION Date <br />Approved as Consiructed <br />1� <br />V/ <br />V <br />a <br />ACKNOWLEGGEMENT OF CONDITIONS <br />The undersigned owner/appiicant hereby agrees to hold and save harmless <br />ihe City of Everetl from any and all daims for damages, cosis, expenses, or <br />causes of action ;hat may arise because of installation and maintenance of <br />ihe impmvement or other righbof-� iay use hereto applied for ar,d furiher agrees <br />to remove same on notice from the City and to replace public property <br />damaged ther� <br />C <br />-/U-/ <br />WORK AUTHORI2ED BY THIS PERMIT MUST BE STARTED WITHIN 780 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO <br />COMPLt�ION. THIS PERMIT MAY BE CANCELLED BY THE (:IlY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATIOIJ. <br />