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Uate ��3 .S <br />. Applicatlon For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Boyden Realty, Inc. 1429 Broadway <br />nwnwr Melling Atldre55 <br />* 6 D Suilders <br />Applicant <br />1429 Broadway <br />lallinp Address <br />Everett <br />L�11f'/ <br />v�nurwo,�.�e�mn. <S'S-/_55� <br />eiap Ueo� � ��— <br />�ahLCWarA�F•e s <br />Tolel iee <br />leaa A00� �ee Pud s <br />Bebnce Due B ��� <br />?d 3 7%z- <br />98201 252-11b6 <br />Everett 98201 <br />City <br />252-1166 <br />Phone <br />Deacrlbe Proposed \Vork Ncw Single Family Resideuce ._ <br />Pro�ectAddressUfknown) 223 - 94th &tree�,S.E.. �verec� � �[� � <br />Attech four (4) copies of plene lor proposed work � DraN lo scale au'. note Yie lollowing as epplicable: <br />• Property Lines <br />•')utlina end dimenslons ol all exlsting end <br />pic+posed slrucluras on iha lot <br />• Exisling end proposad utllitie6 <br />� Centarllne of atreet <br />• Indicalo North <br />• Show any proposetl greding changes <br />• Show mexsuremenls <br />PERMIT CONDITIONS <br />1. All calls for InenecNon shell be medc 24 hra in edvance - phona 259•881 5. <br />2. All work shell 6e perlmmed in accordence wilh lhis p�arm�t and currnnt City ol Everett Design end ConsVuction <br />Stenderde and Spacillcations. <br />3. Call Loeelion Underground Sarvice 4� h.rs. beloie you dig. TnLI FREE NUMBER 1•B00•424•5555. <br />i <br />�_— <br />r\ ' . - ' \ .�:��Y�T <br />Ap � oved for ConS rucllOn � ��1e <br />/ ���� � <br />FINAL INSPECTION Dat��� <br />ApProved as Conslructed <br />everett PUBLIC WORKS DEPA iTMENT <br />� 3200 CeAer S�reet <br />Everett. WA 98201 <br />Phone:259�BB15 <br />ACKNOWLEUGEM':NT OF CONDITIONS <br />W <br />H <br />� <br />� <br />� <br />O <br />� <br />� <br />O <br />a <br />The unde�si�7ned ownr.r/oppliceN hcreby egrees lo I�old mi,l snve hnnn� <br />less ihe Cily ol Everett Irom any and ell claims lor damayea, cosis, <br />eaponses, or causes ol xction thet may erise becausv ol installation <br />end mainlenecca ol Ihe improvomenl or other righFoi�way use herelo <br />apphed lor and lurthei agrees to rerrnve same upon notice Irom the <br />City and lo replaco public property dnmegeA �hereby. <br />� �'. /�� .s �o �� <br />Si9nature ol ApC�licanl 4 �Q <br />WOFK AUTNORIZED BY THIS PERMiT Mi1ST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED ANO THEREAFTER IS TO <br />BE DILIGENTLV PURSUED TO COMPLETION. TNIS PERMIT MAV BE <br />GANCELLED BY THE CI fY UPON ANY STOF'PAGE OF WORK ON THIS <br />PROJECT OVEF 90 DAYS DURATION. <br />