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Applicetlon For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Real <br />Boyden Realty, Inc. <br />dba .1 6 D Buildere <br />Appllcant <br />1429 <br />Descrlbe Proaoeed Work �.9^v Sinele Familv <br />aty <br />ProleM Addrennlil know� ��"� — y'�^ r'�---T==-" <br />Attach four�4) coples cd pl�ne lor propoaed work � D�ew to acele and nota Ihe following ea app�icabie: <br />• Proparty Linee <br />• Outline end dlm5neione ol ell exletinB and <br />p�opoaed etr�cturee on Iha lot <br />• Er.ie11n0 and prc�poead ulillllee <br />PUU��c Worre Permn • �� /2 � <br />ama oeo� � �Yi� ��' � � <br />PuEuc Warb Fas a'7�, b O <br />Tolal F�� �— <br />Uae AOC�. F�� ���a � <br />Bmncs Ou� { 7� � UO <br />• Cenlerline o� etreet <br />• tndicata North <br />• Shaw eny proposed g�adlnp chenges <br />• ShOW me98UfdmBnlB <br />G89y <br />Phone <br />PERMIT CONDITInNS <br />1. All celle lor �napection ehell be meda 24 hre. In edvance • phone 259•881 5. <br />2. All work ehell be perlormed In eccordence wNh this pe�mit end cunent Clly ol F.erecl Design end Conatructlon <br />Stenderda erd Specllicetiona. <br />3. Call LoceUon UnAerground Servlce 4B h�s. before you diq. TOLL FREE NUMBER 1•800•424-5555. <br />-- i ���� �i�-fy- <br />rovad lor ConntrucUon Date <br />J�/,..':�/,1�„-...., Zl�lr�� <br />FINACINSPECTI Date <br />Approved ae ConetructeC <br />everett PUBLIC WORKS DEPARTMENT <br />� 3200 Ceder Sireet <br />Everett WA 98201 <br />Phone: 259-8815 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />H <br />� <br />� <br />� <br />O <br />� <br />� <br />� <br />a <br />The un�lersigned owner/epplicenl heraby egrees lo Y�old and seve heim- <br />lesa lhe Clty ol Everett Irom er,y end all clelms br demuB�^� �osts, <br />aKpensa& ur causes ol ection thet mey arise becauee of inatallallon <br />end inelnlenence ol the ImOrovement or othe� ri0h4ol�wey uae hereto <br />eppGed lor end lurthe� agreee to remove same upon notice Irom Ihe <br />Cily end,to cepl ce ,^.ublic pro erty demeped tnoreby. <br />�, � � <br />,'r<< :�t��� ��,�i._ �l �'%��1�Y <br />—i Deto <br />Slynature ol Appllcan� � <br />�liORU YSTOF DAT[ PERMIT ISESSUED AND THEREAFYER ISITO <br />JL' DII.IGENTLY PURSUED TO COMPIETIUIJ. 1HIS PERMIT MAV BE <br />CANCELLED BY THE CITY UPON ANl' STOPPAOE OF N�ORK OM?IiIS <br />PROJECT OVER 90 DAYS DURATION. <br />