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_� . ........��: <br /> �I -,i`�-�'"5 VUGM1c Wor�e Permn� �C�`�—/ <br /> Date ? 11 93 `U` `"u,��ly G �I ' ( -L�`�, eiao oeo� . 39856 <br /> Aoplicetlon For _ <br /> PUBLIC WORKS PERMIT Pu�ucWo.e�fee � <br /> To�n�Fee <br /> lew�00�FeeGuds ��/' <br /> ena�ce nue S <br /> Print or Type Only <br /> Petercarn Construction PO Box 755 Mukilteo 98275 356-6508 phone <br /> Uwner <br /> Mailing AAdress �'�Y Zip <br /> Ranter Petereon 356-6508 or 324-6280 or 355-0474 anone <br /> Applicent <br /> Mulling Add�ess Ciry Zip <br /> New house <br /> Describe Proposed Work <br /> W <br /> 3►� Ic�wta, 5cra� �E Lotis�z - � <br /> Project Address 1��knownl � <br /> Atlach four l4) copies of plens for proposed work� Drew lo scale and note me louowing as applicab�e: � <br /> • Prope�ty Llnes • Centeil�ne ol streel <br /> • Indica�e North <br /> • OutGne and dimensions ol all exrsting and � Show eny proposed grading changes <br /> proposed st�uctures on the lot � ghow measurements M <br /> • Existing end proposed ulllitles W <br /> DO N�?T WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS � <br /> 1.AII cells lor Inspection shall be mede 24 hrs.in advence•phone 259•8810. <br /> 2.All work shall be pertormed In eccordance wilh th�is permll end currenl City of Evcrelt Design end Conslruclion <br /> Stenderds and Specllicationa. � <br /> 1.Ceil Location Underground Service 48 hrs.belo�e you dig.TOLL FREE NUMBER 1•BOii 124•555;• �`Lv}f� <br /> � nska�l v�tx1 � ��''��jzf,� dr„�t�va�. /�ci yEc� 3C��t� ,� O <br /> q, � <br /> ��,� std � . �"' <br /> � <br /> � <br /> �. <br /> Af,KNOWLEDGEMENT Of CONGITIUNS <br /> �,�y The undersigned owner/apDlicant hereby egrees to hold and save ha�m� <br /> ���-^J�) ---- less ihe GIy o� EvereU Irom any end all cleims lor damages. costs. <br /> - erpenses, or ceuses ol acUon tha� mny arlse because ol Inslalla�ion <br /> — n .. ..n` 1 � / vtn _ _ �� Iry /G 2 end mnintenance ol Ihe imUrovemenl or ather righl�o�•��ey use he�eto <br /> � / �� w� ����� Iflljrf/� -� �/ epplieA for and lurther egrees lo remove sama upon notice Irom Ihe <br /> Y��lx_ �� ��".., DatP <br /> qpprove �Conslr ction City anJ to repince pubhc property demegad lhere y, <br /> l � � , <br /> , �-�-�� <br /> Da� Dete <br /> FI AL NSPECTIU � i ure ol Applic t <br /> qpproved as Constructed ' yyORK AUTHOR ED BY THIS PERMI7 MUST BE STARTED WIiHIN <br /> �-7 PUBLICWURKSOEPARTMENT 1B0 DAYS OF t�ATE PEAMIT IS ISSUED ANO THEREAFTER IS TO <br /> /V� 3200 Cetlar Streat BE DILIGENTLY PURSUED 10 COMPLETION. THIS PERMIT MAV BE <br /> y � Everetl.WA9B201 pROJEGT OVER 90 DAVS �URAT ON STOPPAGE OF WORK ON THIS <br /> � Phona:259�3910 <br />