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Date_ 3-13-95 P�JCTING . � L_-� I o„oi�cwo�wernrmn• �Jr�(„L_= <br /> BiJo Deo1 . 47733 <br /> qpplication For �, <br /> PUBLIC WORKS PERMI� '°°°`"'°„"°° - <br /> .auiFne 6 <br /> �t uea�oo� re�o.,e S <br /> O <br /> �� �-� V �, p n B�Unce Oue 5 �D <br /> Print or Type Only r '^ � � r"^ `� r' <br /> �i �� o o ��,i r� - <br /> vi � � r.� � �n Y u� <br /> f.� M M M <br /> Gcldmark Enterpriaes 915 Stitch Rd Lk �te�{e'ns WA 98258 �34-9656 <br /> pW�e; � Ma�l�n�Atldress ?� ty co -� �ip Phone <br /> r � <br /> '�ic� xc� i , Y` <br /> ii �i � t� r� �� �= w <br /> Krie or Jeanine Granstrom 239-0862 � x �; � � 4; ;}, ,r x _ <br /> Apphcenl Maihng Atltlress Ctly Zip Phon� <br /> Describe Proposed Work ne.w du lex ___ --- - <br /> — —.-- � <br /> Prolect Address lil known) 1911 l l lth PI SW ___ Lot 4 SP 7-94 � <br /> A�tach luur 14� CopieS 0� Plans for propo5ed work� D�aw lu 5tale and note ine lollow�ng �5 apUhcablp: � <br /> • Proyerty Lmes • Genterhne ol stree� � <br /> • Outline ond dimensions of all eKisting and • Indicale North <br /> proposed sduUures on�he lot � Show any proposeA grading changes <br /> • Ezisting and proposed utililies • Show mrasurements � <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> t.All calls Ier Inspection shell be mede 24 hrs.In advance•phone 259•8810. � <br /> 2.All wo�k shell be performed In eccordanca with this permit and current City of Everett Design and Conatruction <br /> Standarda end Specllicatlons. <br /> 3.Cell Locetlon Underground Service 4B hrs.belo�e you dig.TOLL FREE NUMBER 1•800•424•5555. � <br /> a. �Fc-G c uv su cFis c�e•an ai rw tnnes. O <br /> � r�qp r���Iter �ntl unn,rion In Ihe plat �re n�sv nnh�mclamoq�d nny d��ma�P thcieto shull ba rn���i<Prl at Ihe <br /> Jlscre6oncf 1he Putdic. Woiks linpectoi. <br /> ,, Any change in Ihe drWewcry cul musl be approved by R�e PW Irxpeclor.witllh:d prop iine iimlled to exhlinq � <br /> opron�.v�dth. <br /> ' ��Jjusl wu�ei Uoxes lo ytade ul end at conshudicn. � <br /> 4. Sill Irncc�s and/or olher erosion control measures shail be irntailetl by Ihe bulltler al the direcllon ol Ihe P�ihlic <br /> 'Nor;s IrttpcUor. � <br /> �. uoonop c7rainage snau Ue dscharyea: <br /> i•>t� 1 �? 1, d. 7.A o COnn^C I 10 IhP p!��'S slOml tl'OI�SKiP�I. Ct S�!�b h pfOVldPd O� IhP I�Oni Of�hP 10�. � <br /> i.,,�q .� �. '-,; ;�Ilfif'i.l Iq Ihf 1]f5111CllviCli�oi uench drain provided ai the reur vt each ioi. <br /> i ;u�lioi�: ( n�rnv�� :;c• I�dt�r�rotlo !Il,nq�tll�e�cu�aoflhetiFnChdKtIM <br /> �/ / AGKNOWLEDG[MENT Of CONDITIONS <br /> U! t ��(/Q ti __ The undersig�ed owner/npphcenl hereby ogrees lo hold and s2ve ha�m� <br /> � � — less Ihe Cdy o� Everetl irom any end all claims lor damages, costs, <br /> erpenses. or ceuses ol ncimn ihal muy arise because of mslallaUon <br /> -��J� // N�G�"- �/q,/%� and maintnnenr,e nl Ihe imProvemenl or nther right-obweY use herolo <br /> �j,�C�/// i appheA br anA lur her egrees lo remove seme upon no��ce irom ihe <br /> Approve Constru lion � � �� City and �o replace public property demaged thareby. <br /> /' � � � <br /> 3-13- � S <br /> INSPECT � Date Dale <br /> Apprnved as Conslructed Sign re of Apphcai � <br /> WORK AUTHORI'LED BY THIS PERMIT MUST BE S7ARTED WITiiIN <br /> �7 PUBLIC WORNS DEPARTMENT 180 DAVS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> '� 3200CedarStreet PE DIIIGENTLV PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> �� Everetl,WA 98201 CANCELLED BY THE CITV UPON ANY STOPPAGE OF WORK ON THIS <br /> Phona:259•9810 pROJECT OV'cR 90 DAYS DURATION. <br />