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�� <br /> �BfB pumic work�vumu• <br /> Applitetlon Foi ewu.o.o�.• <br /> PUBLIC WORKS PERMIT �e�kWOM.F.. , <br /> .o�.�F.. s , <br /> L�u�ODI Fq P�itl s I <br /> Print or Type Only e.�.�<.o�. s_ <br /> Owner Plea Check No: C 37459 SEPA phone <br /> Appllcat.Detes 07/21/92 <br /> Job Addret 810 304TH ST SE ' <br /> Ownere JENSEN R REITH <br /> Tenenti <br /> Applicant Propoeed Uee: SINC.:E FAMILY RESIDENCE Phone <br /> Deac. of Fark: <br /> 752SF ADDN / REMO�HL / DECR <br /> Dencribe Propone6 Work <br /> OFFICE SET JOB RET <br /> APPRVD FOA PERMl'7�� DAT?_/__/_ BY <br /> W <br /> Project Addreae(II known) � <br /> . Altach lour(4)coplee of plans lor propoaed wo�k•Draw to acele end note Ihe lollowing ea epplicable: � <br /> • Property Llnes • Cenlerune ol etreet � <br /> • Outllne and dimenalona ol all exleting end • Indicale North <br /> propoeed eliuclu�en on the lol � Show eny propoaed predlnp chenpea <br /> • Exletinp and propoeed utllltlee • Show meeeuremente � <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITION9 <br /> 1.All calla for Inspectlon ehell be mede 24 hre.In advence-phone 259�8810. � <br /> 2.All work ehell ba pertrrmed In accordance w�th thle permll and currenl Cily ol Everett Deslpn and Conetrucllon <br /> Standarde end 3peclflcellone. <br /> 3.Call Locatlon Underpround 3ervlce 4B hre.belore you dlp.TOLL FREE NUMBER 1•800�424b655. � <br /> /��t Gr/c?,i r. �,.._„ ,. .f /'��I �i�y.Lc.. ,.�� O <br /> F 7- ��1 Z N <br /> O <br /> a <br /> ACKNOWLEDOEMENT OF CONDITIONS <br /> Tha underelpned owner/applicanl hereby npreen lo hold and eave herm- <br /> leas the City ol Everett from eny and all claime lor damape0. cost4 <br /> expenaes, or ceueee ol acllon thet mey arlee becauee of inalelletlon <br /> and malntenanco ol the Improvamant or other rlpht-ol•wey uee hereto <br /> epplied lor end lurthar epreea to remove eame upan notice �rom tha <br /> App'oved lor Conetrucllon Date Ciry and to replace public property demaped Ihareby. <br /> FINAL INSPECTION Dete <br /> Approved ae Constructed Signeture ol Applicent Date <br /> � PUBLICWORKBDEPARTMENT WOHK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200Cede�St�eet 1B0 DAYS OF DATE PERMIT IS ISSUED AND THEREAfTER IS TO <br /> Evare1L WA 98401 BE DILIGENTLY PURSUED TO COMPLETION. TH19 PERMIT MAY BE <br /> Phone:�69-BB10 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 80 UAYS OURATION. <br />