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� <br />TYPE OR PRINT ONLY <br />Applicatinn For <br />PUBLIC WO�;KS PERMIT <br />PUBLIC WORKS DEpARTMENT <br />3200 Cedar Street <br />Everett, Wq gg2p7 259-8810 <br />Kay/James Piatteson <br />Owner Mailir3 <br />�'� ��STING AUG (I 4 1997 <br />Date 1-22-97 <br />Public Works Permit # _�/O3�_ <br />Building Permit u 54035 <br />Public Works Fee S (�v r <br />15418 29th Ave S� hfill Creek WA 98012 316-8361 <br />,.,-'-- <br />Zip Phone <br />Owner <br />Appiicant Mailing qddress <br />City Zip P�one <br />Describe Proposed Work new house <br />PROJECT ADDRESS (if known) _I O—T Z S 8-{'h [��' � <br />Lof <br />Attach four (41 copies of plans tor pmposed work - Craw to scale and note �he �oll <br />7 l/ _ (t� -`IS <br />'Propeiry �ines •Outline and tlimensions of all existing and proposed structures on ihel�o1ble:Existing and proposed utilities <br />•Centerline ot sireet •Indicate Norih •Show any proposed grading changes 'Show measurements <br />PERMIT CONDITIONS: -'"' """ `"`�vvv i niJ ���vt <br />1. All calls for inspection shall be made 24 hour , in advance - phone 259-8810. J� � - <br />2. All work shall be pertormed in accordance with this permit and current City of Everett'Design and <br />Construction Standards and Speciiications. - <br />3. Call Location Underground Service 4A hrs. Cefere you dig. TOLL FREE NUMBER_1-800-424-5555. <br />� Ke�p city stteeLs cle;m :ll ap times. l',y '"' <br />'1 v�i , <br />S Cwb ri,tter and sidew�all; u� the plat are ncw� and tuidamaged, :ury �]ryn�;� � ��- �1� � ,, <br />,�n�� :. <br />discrelion of'Ihe Public u'nrl:s In:pcctor. S��� � al bete l:�cec. ,�i f <br />-�{�,: �:.�.J;:.��'. <br />t'. Any chm�ge ui the d�ivew;iy cut �rmst ba approved by Ihe FW Inspecror, wu�tij�� j,ro i <br />m Q�Ju . . <br />cxisline apron ti�idUi. �,,_�� f I �in. IiSpitcd to <br />Adju�t warer hoxes to �rade at eud of constrvction. J <br />' .�i�%���'.i rL�'�.�i:n'1 <br />� Dm•ew.p � sh:dl b;: eomplrtely cureci beforo dri�uie on Ih;,m. �NDT= : :"- :,,. <br />" ;tonfl��,p rh;iin;u�c -h�i11 he rli�chatr;rd to thz stonn dr;iira��e ;htb loc u�d d thr Iront ol !h� I�; <br />. /' ° ' <br />-� .-- f��`CW*-�-- S' z.�1 `� � <br />FR�:�L INSPECTION Date <br />Approvetl as Conslmcted <br />ACIWOWLEDGEMENT OF CONDITIONS <br />The undersigned owneuapp!icant hereby agrees to hold and save harmless <br />ihe City of Everett Irom any and all claims (or damages, costs, expenses, or <br />causes of actio� ihat may arise because �f installation and maintenance of <br />ihe improvement or other right-of-way use hereto applied for and furiher agrees <br />to remove same upon notice �rom ihe City and to replace public property <br />damaged ihereby./ <br />� I� , �-/U�� 7 <br />� G: ti.. <br />Sign ure qp � � <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT S ISS ED AND THER[qF7EF IS 70 BE DILIGENTLY PURSU D TO <br />COMPLEfION. THIS PERhf1T MAY BE CANCELLED BY THE CIIY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVF.R 90 DAYS DURATION. <br />