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Data��� Sr <br />Appllcetlon For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Realty, Inc. 1429 <br />Address <br />Puei¢ wo��� Ve�m�1 • �'(j'� `'/�� <br />Bi� Oe�t � ��a '�— <br />Puonc Woika Fe� <br />To��iFee s -- <br />lae� �po� �e� PUE 1 ^� �-1 <br />B�brca Dua = f O� L/v <br />J 6 D Builders 1429 Broadway Everett 98201 252-11E6 <br />Appllcent Mallinq Address City Zip Phone <br />Deecrlbe Proposad Work l�eW SinA=e FBmily Residenc� <br />Pro�eclAddreea�llknownl 211 - 94th Street S.E. Everett <br />Attecii lour (4) coples of plans lor proposed work • Draw to ace�e and note the following as applicablo: <br />• Properly Linae <br />• Outline end dlmenelona ol all ezistinB end <br />proposed atrur.turea on ihe lol <br />• Exleting end proposed ulilitiee <br />• Centorline ol street <br />• Indicate North <br />• Show any proposed grading changes <br />• Show: �easuiemenls <br />PERMIT CONDITIONS <br />1, All calle for Inapection ahell be made 24 hre. in edvance • phone 259•88i 5. <br />2. All work shall bo perlormed In eccordance with this parmit end currenl City ol Everett Design and ConsVuclion <br />Slende�de and Specilications <br />3. Cell Locallori Unde�ground Sarvice 4B hrs. before you dig. TOLL FREE NUMBER 1•800•424•5555. <br />� <br />/ I <br />�' " i �� -� -�L..��'Y��S <br />ApE�,rove�o/C�onstrt�ctip� /� / Detr <br />/ ' <br />�_ � z�� � � <br />FINAL INSPECTION Dete <br />Approved es Construcled <br />eve�e[t PUBUC WORKS DEPARTMENT <br />� 3200 Cedar Sireet <br />EverelL WA 98201 <br />Phone: 259�8815 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The, undeis�g�ed owner/apPlicent he�eby agrees lo hold and save harm• <br />less ihe City ol Everetl irom any and all claime lor damege& coslA <br />expenses. o� causes ol ection thel mey erise because of Ine�alletlan <br />anC memlenunce of the impwvemenl or other riphho4way use hereto <br />epphed lor nnd Iwther pgrees to remove aame upon nolice Irom Ihe <br />City and to replace public property demaBed thereby. <br />.�.u� �� ,e�1�.�:-�«�L _ .a-/y/�s <br />Signature ol Appli ent �� <br />WORK AUTHORI2ED BV THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS �SSUED AND THEREAFTER IS TO <br />8E DILIGENTIY PURSUED TO Cf1MPLETiON. THtS PERMIT MAY BE <br />CANCEI.LED BY THE CITV UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAVS DURATION <br />