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� <br />TYPE OR PRINT ONLY <br />r <br />APPbcplron Far <br />PUBLIC WORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar S�rcet <br />Everett. WA gB201 259-8870 <br />�t P J 19!! <br />`ING - <br />Data <br />P�blic Works Permlt N <br />Bu'ding Permit N <br />PubGc Works Fee 5 <br />6-23-97 <br />���/R¢ <br />SSI15 <br />Zo- <br />Welch's Cone[ruction 6332 76th Dr S': Snohomieh 9829G 337-3528 <br />Owner Maihng Add�ess Cit � <br />Y •-�P Phone <br />Owner <br />Applicent <br />Describe Proposed Work <br />Addregs <br />houee <br />Cily <br />--- Lp — - -� -- Phone <br />- _----- <br />----- _ --- <br />07-01-9� 8713AM <br />- _ --- — -- N 55T15 <br />-- <br />BUILDIINi 746.80 ----- <br />PROJECTADDRESS(ifknown) __ 24l 9�th_P_1 SW_____ ___ _Lo[_"L_�M'il'�R6apdow_ <br />Atinch fom �4) copies ol plens lor proposM work - Drew to scele and note ihe lollowing 11 epplic9ble� �C�I�' �'� <br />�Properly Lmes 'Oullinn and dimensions ol all eMlstin and m • � 4'� <br />9 p Posed sliuclure� on tha lol E.Istlrg ��}r,d uyyy�� <br />'Centedine ol sheet 'Intlir.ale North �Show nny proposetl grading chanqes 'Show measurer�nts �9,� <br />W <br />H <br />♦�A <br />V/ <br />� <br />O <br />� <br />PERMIT CONDITIONS: M 31163 � <br />1. All calls for inspection shall be made 24 hours in advance - phone 259-88 ticu 7�0•� <br />2. All work shall be performed in accordance with this permit and current Cit�Z�requesi�p and <br />Consiruction Standards and Specifications. 1296.00 O <br />3. Call Location Underground Seivice 48 hrs. before you dig. TOLL FREE 1�l��-�Q.�q.6,5�, �� <br />1 OIAL �116. <br />CHEK <br />F...n ruc �h,..i, , �.:m s� •dl nnir A OR 717 <br />� wb ridl�i ;n�d ,iJ�w;dl, ui Ili: pl;u ai. u;" :unl wniaiun �rd ,n�� d;uu:iF c ih.ir�o .h;Jl L� u-pla�rd �n il <br />Ir•ciruon o1 th I'uhh� 1l'ot4, lu�p�clo� <br />1m rh�m�r m liie dm��•t .�v cni nm:i hr � piocrd b� Ih� 1'N Imp•cioi widdi at p�nn hn� hmued to <br />�i•imt api�m w�dlL. <br />�,Ipi.y u'�irl bnrc• In �,indr si inrl n� coq�'tn�chnn <br />i nivr.wa�, .hall br rompkich cmrd hrloic dnvmr on them <br />I;.,,�ttnp �haina��: .hall b; di �h:u�.r,l tn ilr u�': ;Innn di:un �_i m <br />7 <br />r � /�/ � /-��r <br />���C'l�(/�/ ( �t_ <br />Appiuvrd Iw Cons'liurbnn <br />¢ ,��' a.�:.. <br />fINAI INSPf C IION <br />ilpprnvFld ns LonslniclvA <br />�'�� � <br />�� ,z-. <br />Da� <br />/-26 -?ff <br />_ � _ _ Date <br />ACKNOWLEDGEMENT OF CONUIiIONS <br />The unAersigned owner/epplicant hereby agrees lo holtl and snve harmless <br />Ihe Cily ol Everelt Irom eny ond all claims lor damages. wsis. enpenses, or <br />causes ol aclion Iha1 may orise becnuse ol installallon nnd maintenance ol <br />tlx! impmvemenl or other right-ol-way use hereb applieed for and lurther egrees <br />to remova same upon notice from ihe City end �o rapla[e public preperty <br />damagpd Ihereby. <br />p'`^ �• �,�A�N�I <br />Signatur IApylicanl Da1e <br />WOqk AUTHORIZFD Eir THIS PERMIT MUSi BE STARTE� WITHIN 1A0 �AVS Of DATE PERMIT IS ISSUED AND THEPEAfTER IS TO BE DILIGENTLV PURSUED i0 <br />COMPLE tION IHIS PFf7MIT MAY BE CANCELLED Ov iHF CITV UPON ANV STOPPAGE OF WORK ON THIS PR0.IECT OVER BO DAYS DURATION. <br />