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� <br />� <br />Apphcation For <br />PUBLIC WORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA98201 259-8810 � <br />V � a <br />oate __ _ _ _ __6-23-97 —_ <br />Public Works Permit M `'��/ �� _ <br />Build'ngPemitN.__55i22 _ __ __ <br />��i';'.!:i'��t _ NO � <br />TYPE OR PRIN f ONLY � Pubiic Works Fee S_� _ <br />Welch's Conetructlon 6332 76th Dr SE Snohomish 9p290 337-3528 <br />Owner <br />Malling Address <br />Phone <br />Owner <br />Applicant Meiling Adtlress City Zip Phone �� <br />Descrlbe Proposed Work new house ___ <br />PROJECTADDRESS(Ifknown) 205 99th Pl SW Lot 11 �e¢JdQ=agapw _ <br />M 55972 <br />Aflach four (4) coples of plans 1or pmposed work - Draw to scale end nnte th:lollowing If epplicable: �JIIDII'� bn.l� <br />'Proparty Lines 'Outllne end dimenslons ol ell ezlsting entl propoaed s�ructures on tha lot •Exist� ig ��etl ulpl�le� <br />•Centadine ol atreet •Indlcole NoAh �Show any proposed grading chenges •Show measurer�I� 6�. � <br />uu rvu i rvni i r_ ctwrv i nia �nv� pRIVEHAY 20.00 <br />PERMIT CONDITIONS: 94� <br />1. All calls for Inspection shall be made 24 hours in advance - phone 259-88qj�, ,,,c � <br />2. All work shall be performed ir. accordance wlth this permit and curr�nt CI!�� H��erett 311 and <br />Construction Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE �F�,i �=�4-5555. <br />1296.00 <br />I F;er i cily strats cican nt all hnu= �� 330.00 <br />I TOiAL 2589.60 <br />Cwb �nllri ;wJ .iJew�dl� iu ihe plal ;uc uc�� ;uul u �d;una��rd. ;m� daw,�� c tlieirtu sh;dl bc icp��� <br />disc�.tiou of Ih; FuLGc \t'o�k.e Incprci�,i A OR 773 <br />r� nny chanre m Ihe dm�ew9v cin must bc rpprnvcd hy tlic I'�a In>p�cioi uidUi at pro;, Im: lunncd to <br />:ustintt ap�on widih. <br />' Adjnst walcr boxcs tn ���dc at cnA nf con�tnirtion. <br />;s ni�vru•a�. chall bc r�iupl:i.lc rur� d brliur dii�im� nii Ihrni <br />„ I:�� .It,��� ,I�,nua . hal' I�r ,li rlcu� r�l i�. tlir i�;' �oiin dr.iii �.t:in <br />ACKNOWLEDGER:ENT OF CON�ITIONS <br />The undersigned owner/applicanl hereby agrees to hold end seve hartnless <br />the Cily of Everelt fram eny end nll cleims lor damages, costs, expenses, or <br />ceuses ol ection that mey arise bacause alinstallation and rnaintennnce of <br />Ihe Impmvemunl o� other dghl obway use hereto epplled lor nnd further egrees <br />lo remove seme upon natice Irom lhe City and to r<pluce public properly <br />demeged Ihereby. <br />-�./�.� <br />Siqnal of Applicant Date <br />WOPK AU7HOFIZED BV ?HIS PERMIT MUST BE STARTED WITHIN 190 DAYS OF DATE PERMIT IS ISSUED ANO THEREAFTER IS TO 8E DILIOCNTIV PURSUED TO <br />COMPLETION. THIS PERMIT MAV BE CANC[LLED BV THE Clh" UPON ANY STOPPAGE Of WORK ON THIS PROJECT OVER 90 DAVS DUHAiION. <br />