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,_ <br /> Dete r` v�m��wort.v.�mu. <br /> Appllcatlon For Biev o•o��• <br /> PUBUC WORKS PERMIT Publ¢WorbFu , <br /> .e�.�F.. s <br /> un eoo�ro r�ia S <br /> Print or Type Only B�bne�Du� t <br /> Plsn Check No: C d3820 58PA <br /> Owner Applicet.Data: 03/17/94 Phone <br /> Job Addraaei 325 1b9TH PL 6E <br /> Ownarf LAWRENCE MICHELE M ' <br /> Tanent� <br /> Proposad Uso� BINGLE FAHILY RESIDENCE <br /> Appiicent Desc. of Work� Phone <br /> FANILY ROOM ADDITION — 44B6F <br /> Deec�ibe Proponed Work _ OFFICE SBT JOB 8ET <br /> APPROVED FOR PERNITt DATE_/_/_ BY _ . <br /> -- W <br /> Pro�ect A4dreee(il known) _ � <br /> Atfech lour(4)coples ol plana lor propoeed wo�k•Orew fo ecele end nole Ihe lollowing aa eppliceble: � <br /> . • Property Linee • Centerline ol elreet � <br /> • Outline end dlmenalons ol ell exietinp and • Indicale North <br /> prOpo6ltl s��uClure7 On�hB lol • Show eny propoaed pradlnp thanpee <br /> . � • l:xlatinp and propoeed ullllllee • Show meaeurementa � <br /> - � <br /> ��,�. ,r� DO NOT WRITE BELOW THIS LINE O <br /> "'A' t PERMIT CONDITIONS <br /> 1`��'� ' - � i.All calle lor Inepection ahell be mede 24 hn.In advence•phone 259-881 O. � <br /> ��k!� �� � � 2.All wo�k ehall be pedormed In acco�dance with Ihle permit end cunent City ol Everett Deelgn end ConeVuctlon <br /> �@�•:'.,1� ; Slandarde end Specllicetlone. <br /> ��`'-�!�� ' � � 3.Call Locatlon Undeipround Servica 4B hra belo�e you dlp.TOLL FREE NUMBER 1•800-424•5555. � <br /> i O <br /> i'UBUC WORKS PERMIT � <br /> NOT REOUIRE� � <br /> BY ' �� <br /> D AT E `� � �- O <br /> a <br /> . ACKNOWLEDGEMENT OF CONDITIONS <br /> The undeieigned owner/applicant hereby e0reee to hold and eave harm• <br /> less Ihe Cily of Everell liom eny end all cleimn lor demagee, coals, <br /> eKpenses, or ceuaee ol ecll�n Ihat may erlee bacauee of Inetelletlon <br /> end mainlenence ol the im�rovemxnl or olher rlghl-ol•way uae harelo <br /> epplied lor end lurther egreea lo remove eame upon notice I�om Iha <br /> Approved lor Conetruction Dele Clty and to�eplace public p�operty demaped Ihe�eby. <br /> FINAL INSPECTION Oa�e <br /> Approved es Conelructad Signalura ol Applicent Date <br /> � PUBLIC WORKSDEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200CederSlreet 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett.WA BB20t BE DILIGENTLV PUHSUED TO COMPLETION. THIS PERMI7 MAV BE <br /> Phanr�159�flfl10 CANCELLED BY THE CITY UPON ANY STOPPAGE OP WORK ON THIS <br /> nr� ir��r nvrn nn nnv^ ni mnTin�l <br />