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8/27/93 <br />Date <br />Ap�licetlon For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />:h St ' <br />Address <br />1361 <br />PuElrt Wm�� Pnml� • <br />aiao o.o� • 41839 <br />v�ei�c wo�w� F.� — <br />tol�l Fea � <br />Lau �p0� Faa P�iE � <br />BH�nn Due / <br />Owner <br />Appllcanl Mellinp Adtl�eea City Zip Phonn <br />Deeaibe ?ropoaed Work New gaiage <br />Pro�ect Addrese (II known) <br />716 94th St SE <br />Attech four (4) coples ol plans lor propused work • Draw lo acele and note the lallowing as applicable. <br />• Property Lines • Centerline ol atreet <br />• Outline a�d dimenelons ol all existlng and • Indlcele Norlh <br />propoaed sl�uclures on Ihe lol � Show eny proposed preding chengPa <br />• Ezlsling und propoeed utllltiee • Show meaeurements <br />PFRMIT CONDITIONS <br />1. All cella for Inepectlon chall be made 24 hre. In edvence - phone 2b9�8810. <br />2. All work ahall be perlo�med In eccordance with thie permlt end current Clty of Everett Desiqn end Conetructlon <br />3tandards and Speclficetlone. <br />3. Call Locetlon Underpround 3ervice 4B hre, before you dip. TOLL FIIEE NUMlER 1•eoo�2a-ss6a. <br />PUBLIC WORKS PERMIT <br />NOT HEOUIRED <br />BY B <br />DATE 9 3 <br />Approved lor Conelruction Dale <br />FINAL INSPECTION <br />Approved ae Conalructed <br />�PUBLIC WORK9 DEPARTMENT <br />3200 Cedar Straet <br />Eve�e1L WA 88201 <br />Phone:269•8810 <br />Dele <br />ACKNOWLEDGEMENT OF CONDffIONS <br />W <br />� <br />� <br />� <br />Tha unde�sipnetl owner/applicant hereby eprees lu hold and sava herm� <br />less the Clty ol Everelt Irom eny end all cleima lor damagea coete. <br />e�penses, or ceuaes ol ectlon Ihat mey erlee beceuee ol �natalletion <br />end mainlenence ol the improvemanl or other righl�ol-wey use hnrelo <br />apPlied for Afld IuI�hP1 ByICCS �O remove same upon notice Irom the <br />Cdy and �o reGlace pu6lic property damaged thereby. <br />Signalure ol Apphr.ant Dale <br />WORK AUTIiOFIZED BY THIS PERMIT MUST 8E STAqTED WITHIN <br />1B0 OAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WOFK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />