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Date �/21/94 P��„�wo,..P»,m��. � <br /> Applicetion For jC NOSTI NG $ - z� -9� n�au o.ai • 4� <br /> PUBLIC WORKS PERMIT °°°°°W°��,°°° -- <br /> ioiel Fee s <br /> ., leeaA001 fnlFd�O s <br /> Print or Type Only , , , ew�a�«o�. s ��n°—" <br /> Mark Selby 1222 Sprin�;brool Rd � I.ic Stevens 98258 • ?34-7400 <br /> Owne� Ma lip9 AdAress , ,�-, � GIy �� � ZiP Phone <br /> Curt Sohnson 337-4733 , , �. ` " <br /> '�� , . , �„ � <br /> . Apphcant Ma hng Address City 2ip Phone <br /> Hew duplex - Basic 203 <br /> De�cribe P�oposed Work <br /> - - - W <br /> Prolect Address lil known) _ ����/J R A t [�' • 7�"Av�, S = � <br /> Atlach lour 14)coples ol plans for propesed work- Draw to scale antl note�ne�ollowing as appl�cahle � <br /> • Property Lines • Centerline ol street � <br /> • Outline and d�mansions o1 all c.istmg and • Indicale North <br /> proposed slructures on Ihe lot • Show any proposed grading changes <br /> • Ezisting and Froposed utilities • Show measurements � <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIS CONDITIONS <br /> 1 All cells lo�inspectlon sholl bn mede 24 hrs.In advence-phone 259•8810. � <br /> 2.All work ahall be performed In eccordance wilh thla parmlt end current City ol Everetf Design and Construcllon <br /> Standerds end Specifl�etions. <br /> 3.Cell Locetion Underground Service 4B hrs,before you dig.TOLL FREE N�MBER 1•800•424•5555. � <br /> �� � <br /> 7. �/ISft:L��if'oi� !�/ l. /'C.Si�'nl.rl S��rin,("C��r �y(l�.�i „� c ��iii���icnCC <br /> !✓�fA �'fie r.�;v,iz.•,in11 nf Nl"/'A J��n</v.-c/ /�'D /� Rrqu.aED, O <br /> I�-� L/f u of l�,i Oi-��Ai.�G T//E .Si�,ci.v.r LF�C SysTPi✓r A {�'r /l�D.P.�.vT <br /> /��lAf/ U'E /.c�STACCFD [�oTNi.V C�c�S! /',c'odrn.iT� O� TN/.( LOT /�'.r rCRYRiO � <br /> /e/ TyE Na✓. ?d� /99K lE�A Fi'r�•� TS.t��AGEJ Ed�E�.'/��JIS. /N zp�r Lieu � <br /> /�r F'rvvi�nf 5f�ri.i,flir o�- f�'J��/rtnf 2 Frc �ri4rslraL6` 4�/'i-C�'�� �✓rnnl"[,y�ni� O <br /> �'l)? « GC D�"O✓iC�i'J= <br /> -� �"y✓ai✓ay� h)NS� hP 4 �miq�n.vn� OF ZOY`f. u.iv�c �F v.�n/�f./,-.,�.1i•� !1�C .Se,p tn�� <br /> c/iy�'�.y Jt��'vncC W��16 �r nii.t.CCertr /�r94� ��f /3-u:' ��-i✓CWnY m✓S/ l,�• � <br /> �qvC o� Cuitb..r �'/�C n�'bli( l(./�W• . <br /> �'. S�e.�•- fnnnctTinn S/rolL bc /�•- Lc/�'r �r 7ev�� 7�i:>�o� d DT/rd u�Ry /_'.�/99Y <br /> �7rJ ��iti- Ci�� SI'.i��qi�✓J (n0/ 4.[�� GrCiS�- <br /> i i ACKNOWLEDGE6!ENT OF CONDITIONS <br /> �! /yE�[A�O'. llk�i7 /PE z'i✓SjAUC/) /�ii�/C,� TD O[[Ui'�iv[j� <br /> —' Ju, n� � ��� ������ _ ihe undersigneA owner/applicaN hereby agrees to hold and save h�rm� <br /> less the G�y ol [verett Irom any and aU claims loi damages, costs. <br /> ekpenses, or ceuses ol action tha� mny arise because ol installatlon <br /> _� _'---/� ..�. ll and maintenance of Iht improvemenf or Mhei righ��ol�waY use herelo <br /> �� appi�eA for and lur�her agraes to �omove same upon notice Irom Ihe <br /> Appro �,d f ' tion 7� � � Da e City and lo raplace pubhc properly damaged therehy. <br /> " �,-�� `j <br /> ,. � _ic 9�— / , I <br /> FW L ECTION. �` Dale .{� i�' � Sd �7y'� <br /> Approved es ConsVucled S'g ature ol Applic� nl Unle <br /> �7 PUBLICWORIiSDEPARTMENT W RK AUiHORIZcD 8Y THIS PERMIT MUST EE STARTED WITIiIN <br /> ,�� 3200CederStree� 18C DAVS OF DATF PERMIT IS ISSUED AND THEAEAFIER IS 70 <br /> Evera�6 WA 9B2Ct BE DIUGENTLV PUFSUED TO COMPLETION. iHIS PEFMIT MAY BE <br /> Phnne:259�88'0 GAIICELLED BY TNE CITV UPON ANV STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAVS DURATION. <br />