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� <br /> , <br /> � <br /> ^� <br /> ; ,� <br /> ; <br /> � <br /> � �����=� <br /> i ;i <br /> 71 <br /> � <br /> Date F.11qlLSt 1�� 1987 PublicWorhsPermllu � I <br /> Application For em�.oeo�.+ <br /> PIJBLIG WO�RKS PERMIT . � P°b°�V�a�ksFeo � <br /> Tolal Fee $—�.+— <br /> ,� / Le55Appt Fee Ppid S <br /> Print or Type Only /'�� �� o��a�=�o�a s <br /> t v�D <br /> ��ilder Constsuction Co�any, 2006 N. State Street Rellingham, WA 98225 733-2060 <br /> Owner Mailing Atldress City Zip Phone i <br /> Reid, Middleton & Associates, Inc. , 121 North Sth Avenue, Suite 200, �c3roncs, PL� 775-3434 � <br /> Applicant Mailing Address Ciry Zip phone � . <br /> I <br /> Dsscribe Proposed Work AsAhalt BatCh Plarit I <br /> ! <br /> ti � <br /> Proiea address�a known� _15th Street and winter Street ,�, ' /,f /`y � ST _ � <br /> Attach four(4) copies of plans for propcsed work- Draw to scale and note the followin9�=applicable: � � <br /> v Property Lines o Centerline of street /w ��� <br /> • Oulline and dimensions o� all existing and • Indicate No!th V� <br /> proposed slructures on the lot O Show any proposed grading changes ��, <br /> 8 Exisfing and proposed utilities o Show measurements � ' <br /> DO NOT WFITE BELOW THIS LINE � <br /> PERMIT CO�•!DITIONS <br /> 1. All calls for inspection shall be made 24 hrs. in advanca- phone 259-8815. � <br /> 2. All work shall he performed in accordance with this permit and current City ol Everett Design and Construction <br /> Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800•424-5555. � <br /> ��� �i`�,�����C'a� /�,/n5 S�C/��' � �' �U '�� <br /> ,� ��J�cY G��i �� /�y-u �e., c�-r �• � <br /> / �7 � <br /> d N <br /> � <br /> � <br /> ACKNOWLEDGEMENT OP CONDITIONS <br /> The undersigned owneUapplicant h�reby agrees to hold and save harm- <br /> less the City o( Everett irom any and all claims for damages, costs, <br /> --.��'�_ - -- expenses, or causes ot action thal may arise because of installation <br /> -" � - � and maintenance o( the improvement oi other right-of-way use nerelo <br /> . ., , ... �,, , <br /> —=r= �== —� applied lor and �urther agrees lo remove same upon notice from the <br /> ApP�oved for Construc)'�` Dale Cit �a d . <br /> _,�lG��c<%a� — 5 ,� p ce � er y d. egec�efeb� J/y. <br /> _ .' IL�G-z� ,/.��� ��` �/�� � <br /> �-Z/-�� i� -/ �/ � , f <br /> FINAL INSPECTION Date : �- / � <br /> /�i"�ar�'=- ��, l/i� �-C��,1-Zc..;i �%�/LJ�C% <br /> � . � . <br /> Apnroved as Constructed ,9fc�n�ure of Applicant Date <br /> i•verelt PUBLIC WORKS DEPARTMENT `-�dOflK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> � 3200CedarStreet 180 DAYS OF DATE PERMIT IS ISSUED ANO THEREAFTER IS TO <br /> Everett, WA 98201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE . <br /> Plione: 259-8815 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PRUJECT OVER 90 DAYS DURATION. <br />