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�ate_3=11 95 TG �aSTING APR u � ���,o � <br /> Pubi¢Worx�Permn� �5��3�_ <br /> Application For e�aa oeoi . 47732 <br /> PUBLIC WORKS P�13MIT — � <br /> Pu�i¢Wor�e fee � <br /> �t To�q iee S <br /> �� lp�!�ppl Fee Pa�E S I <br /> Print or Type Onry � �'J p p p p �y � B�IanceDue S Z� <br /> v10 oCl � o <br /> �" M �p CJO �U p .+ <br /> tr'1 .+ �O Cl CJ M (.I �l I <br /> [� .-� ..� M M p i <br /> Goldmark Enterpriaes 915 Stitch R8 S[evens WA 9'8258 334-9656 I <br /> Ow�er Mailing Atld�ess m � Cqy t�.� ^ 2� I <br /> i � � �ii xr� �`' � i� p Phon_p— <br /> Krie or JeaninP (;ranst:om 239-08� � � � " F� LL' <br /> J I � �. U <br /> fu fL (' <br /> Apphcnnt Mailing AtlJress " — <br /> ���y Z�p Phone I <br /> Describe Proposed Work _new dupleX I <br /> ProlectAddress�ilknownl 19Z3 lllth Pl SW Lot 2 SP 2-94 � � <br /> Attach loUr(4)copie5 0l plens lOr propo5ed work- Draw to SCale and nolr, �he�ollowmg ps applicabie�. � I� <br /> • PioPeny Lines � , <br /> • Outline and dimensions ol all eKislin and � �%en�erline of stieet I— � <br /> 9 • Indicate iio�th �� <br /> proposed structures on ihe lot • Show nn � <br /> • Fvisting and proposed ulildies Y Uroposetl gratling changes I <br /> • Show measurements <br /> DO NOT WRITE AELOW THiS LINE � <br /> PEqM1T CONDITIONS O <br /> 1.All calls for inspection shall be made 24 hra.in edvance•phone 259•E3810. <br /> 2.All work shall be performed In cccoidence with this pe�mit and current City of Everett Design end Construction � <br /> Stendards and Specilicatlons. <br /> 3.Cell Locatlon Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 7•$00-QZ4•5555. <br /> �. 1-PCp Ufy tir(•PK(IPOh UI pll�IIII(�5. � �I <br /> S. C���b rj'dtPf!I�tlSIC1CWpIV� If1 ihP�ilpl Orn nA,,.,nnCl��n�fOmOqnrl flny rlNv�qf IhP'pip�hOq hP�P;�IO�P•�(1t IhA � <br /> JISu�etion ol Ihe P!�bllc WorAs lixpec:i�:�. - � <br /> 6. Any c honqN In Ihe d�lveway c!�1 mi rsl Ue opprovecl Uy Ihe PW �inpec tor,widih at p�op Ilnp Iimlle0 to exi�tO�Q <br /> op�on�,riair,. � <br /> 7. Hdji�l waler boReS lo yiaUe al entl of cornlruction. <br /> �4. Silt IPrlf Pti Of1C1Jpf OIhPf 6fC510f1 COflif0l R1@OS�1fBS Sh011 b@ Ir1ti(111P(1 hY ihP hl)IIC1Pf Ol If1P qtr�c Ilqn of the Publ�c � <br /> Wot6s InSpcclor. li <br /> 9, kooflop droinuqe shan be dRc:harqea: O <br /> �o�� �•2,i. E, 1,•q. � Connec9 to 'h@�ICII'<SIpI�I C114111 cVK�PR� (1 SIVb K pfO�ilflp(1(1�ihP hpfl� OI IhP IOI. <br /> lols 4 8 S: CGMeU 10 Ihe lol's inUivltluOl tiench Uruln provlGecl al Ihe rear Of e.uch Ict. � <br /> �, c7ldlOn: Carp itunl bP 101 pn nol Io<Ik�l�pl IhP aiPO pf IhP Irench diahli <br /> ��7 ACKNOWLEDGEMENT OF CONDITIONS <br /> --T���5 The undersirned owner/epplicen�heieby agrees lo hold entl seve hvm� <br /> less Ihe City of EvereU Irom eny end all c!aims for demages, ,;osts, <br />'i expenses, or causes ol aclion Ihat may arise because ol Ins allation <br />� ��� �/� and mainlenance of ihe improvement o�other right�obway us a hereto <br /> i Approved}y C trucL m apphed lor and lurther agrees lo remove seme upon notice h•;m ihe <br />( C ; � ���e City and lo replace pubhc property dnmaged Ihe�eby, <br /> ---� a' 3� - � � O 3-13-9S <br /> FINAL IN CTION Uale <br />, Approvetl as Const�ucted Sig G•e ol App6cant Date <br /> ,� PUBLICWORKSDEPARTMENT W K AUTHORI2ED BV THIS PERMIT MUST BE STARTEO WITHIN <br /> y 3200CedarStreet 1B0 DAVS OF DATE PERMIT IS ISSUED AND THEREAFTEq IS TO <br /> I� Everell,WA9B201 BE DILIGENi�V PURSUED TO COMPLETION. THIS PERMII MAV BE <br /> Phone:258�8810 CANCIiLLED BV THE CITV UPON ANV STOPPAGE OF WORN ON THIS <br /> PROJECT OVER 90 DAVS DURATION. <br />� <br />