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Dete 9�z0/93 PULi�cWor��Permil� <br /> 0iea Deo� • 42069 <br /> Applleatl0n For <br /> PUBLIC WORKS PERMIT ���KWor��iee <br /> Toiei Fee � <br /> leu�Oul ise FUE � - <br /> B�i�Ms Oue �_ <br /> Print or Type Only <br /> Cole Mike 16521 Awy 99 Ste B Lynnwood 98037 743-1555 <br /> Ownar Malling Addrese City 2iV Phone <br /> Troy Olson 743-1555 <br /> ' Appllcanl Melling Addreas City Zip Phone <br /> Describe Proaoaed work . 576ef detached garage __ __ <br /> - W <br /> Prolecl Addresa(il known) 2216 100th St SE __ � <br /> I Altech low(4)coplee of plen:�lor pronosed work• Drew to ecele and notn tht�lollowlnp es app'iceCle: � <br /> � Property Llnes � Centarline ql street Iw <br /> • Outline end dimnnelone of ell exlating end • Indlcale North ' S� <br /> proposed alructureeonthelol � ShoH eny prnnosed gredinp chenpoa <br /> • EMislinp end proposed utllitles • Show mees�n�ments M <br /> W <br /> DO NOT WRITE BEIOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 7.All celle lor Inspoctlon ehell be made 24 hre.In edvence•phone 259•8810. � <br /> 2,All work ehatl be perlormed In er,cordance wlth thle permlt end curtent Cily ol Everett Oentpn end Constructlon <br /> Stenderda end Speclfications. <br /> 3.Call Locetlon Underpround Service 48 hrs.belo�e you dlg.TOLL FREE NUMBER 1-800�4246b6b. � <br /> O <br /> � <br /> PUBLIC WORKS PERMIT � <br /> NOT pEOUIRED O <br /> I Bv 6 <br /> DATE �� �j_ a <br /> I I <br /> I ACKNOWLEDGEMENT OF CONDITIUNS <br /> The untlersigned awne�/applicent hera6y ayraes lo hr,ld end aeve harm� <br />�i lees �he. Cily of Everelt irom any end ell clnin�s lor damages, costs, <br /> e■penses, or r,eubes ol eclion that may erise beC�ausa ol installation <br />� and mainlenence ol lhe irnprovemenl or o�her riyhPol•way use hareto <br /> epplied tor end lurlhe� egrees lo remove e�ma upon natice Irom Ihe <br /> Approved lor Conetruction Date City and to replace puhlic prope�ty demeged Ihereby. <br /> FINAL INSPECTION Dele Dete <br /> Approved as Conatructed Signature ol Applicent <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> � PUBLICWOFKSDEPAFTMENT 1B0 DAYS OF DATE PERMIT IS ISSUEP AND THEREAFTER IS TO <br /> 3200 Ceder Sireel BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Everet6 WA 98201 CANCELLED BV THE CITV UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:25'd�BB10 PROJECT OVER 90 DAYS DURATION. <br />