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DBSP.L��_ � <br />Apv��cetlen For <br />RU�LIC WORKS PERMIT <br />Print or Type Only <br />/ <br />PveucWan�Permn• 8Y /Zo <br />a��,�,o�.� /3��_r — <br />Pu0lkWorh�Fee ` ��� O, <br />TON�Fu — <br />Lau �p0� Fae PmU i_— _' <br />B�I�nceOu� � �• C�l\_ <br />Boyden Realty, Inc. 1429 Broadway Everet[ ;Q201 252-]166 <br />Ownar Malling Addreas Cdy �.ip Phone <br />Bo 2en Realty, Inc. <br />dba J 6 D Buildere 1429 Broadwa� Everett 982U1 252-11G6 <br />Applicant M.IDnpAddress Cdy Zip Phone <br />Deecribe Proposed Work New Sin¢le Famil eeidan • _ <br />Pro)ett Addiese (il known) [ie — <br />Attech lour (4) coples ol plane for propoaed work • Draw to acale and note tha fol� :wing es epplicable: <br />• PropeAy linea t Centerline ol slreet <br />� Outline end dimenaiona of ell exiatinp and • Indicate North <br />proposed et�uctures on tha lot • Shc�w eny Rroposed Bredinp chen8e5 <br />• Exiatlng e�d Rroposed utlllties • Show meaeurements <br />PERMIT CONGITIONS <br />1. All calis for Inepectlon ahall be mede 24 hra In advance • phone 259•881 5. <br />2. All w��k ahell be paAo�med in eccordence with thle parmit and current City of Everett Dealgn and Conetructlon <br />Stendaida and Speci11ce0ma <br />3. Ce:l Location Underground Service 4B hra. belore you diq. TOLL FREE NUMBER 1•800•424•5555. <br />�% �1.� f�/�- � <br />App� lo� Conetrucllon Oete <br />�%f�...�fcJ� 7-��-�3fo <br />FINAL INSPECTION Dnte <br />Approved ea Conetructed � <br />everett PUBLICWORKSDEPAR�MFI�' <br />� 3200 Ceda� Slren� <br />Everett. WA 90201 <br />Phone: 259�BP15 <br />ACKNOWLEJ(iF.MENT OF CONDITIONS <br />� <br />� <br />� <br />� <br />� <br />O <br />a <br />The undersiyned owner/epplicant hereby agrees to holtl end seve harm� <br />less In9 City ol Everotl hom eny end ell cleime for Aeneges, coats. <br />expenses, or causes of action ihet mey erise because cl inetallptlon <br />end maintenence ol lhe improvc.. " or olher righ�•ol-v.nv use heret0 <br />epplied lor end lurtha� apreas to �ert�ove same upon nolice Irom the <br />City anct to repiece publ�. property damapod thereby. <br />'CJ �. , � /�-��� %'-J� -r / <br />igneture ol Applicent Dete <br />WURK AUTHOfiIZED BV THIS PERMIT MUST BE STARiED WITHIN <br />1B0 DAV.'i OF DATE PERMIT I� ISSUED AND THEREAFTER IS TO <br />BE DILIGENTIY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BV THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PFOJECT OVEP 90 DAYS DURATION. <br />