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4-21-93 '' <br />Date : <br />Applitallon,For <br />PUBLIC WUR�S PERMIT <br />.Z <br />i' i <br />Print or Type Only � ;:; � <br />�.. <br />CJ �li <br />1' <br />�� �A <br />Dill Guetavson .' <br />CAffIRY <br />Appllcenl <br />Puplm Wo�F� Permit � _�/y �- _ I <br />Bbp UeOt • _ I <br />Pubi¢ Wod� fea <br />Totel Fee S <br />Leu �pD� Fee P�id S <br />20°� <br />B�i�ncs Due i <br />Ol�7 - .'�'.='s�c/ 7�; ; / <br />PO flox 2702 I,ynnwoo3 t4A 9P03�i 7P8-Gnyf� <br />nu`cas ,, ciry <br />�:i <br />�_'. � ui <br />r� - � <br />-1 n �. � <br />/�VUICDS <br />Zlp <br />Dascribe P�oposed Work _!��tiqetion and F'.evegetntion nlonq Silver I.al:c Cr3e1�-. <br />Pro�ecl Address �il known) <br />Atlach four (4) c, ples ol plans for proposed wo�k • Draw to scale a,id nole the lollowing as applicable: <br />• P.operty Lines • Centr,�line ol street <br />• Outline and dimenslons ol ell exisling and • Indicate North <br />p�oposed slructures on fhe lot � Show any proposed greding changes <br />• Exls�ing and proposed utili�ies • Show measuremenls <br />PERMIT CONDITIONS <br />1. All cells lor Inapection shell be mede 24 hfs. In edvenca • phone 259•6870. <br />2. All work shall be peAo�med In eccordence with thls permll end cunent Clty of Everett Daslgn end Conalructlon <br />Standarda end Specllicatlons. <br />3. Call Locetion Underground Servlce 48 hre. before yau dig. TOLL FREE NUMBER 1•800•424•5555. <br />y`, C(/Ov,� �� fP ��ric �,�i_ iC�� �,> «�` !os��i .fy i/;; <br />C/T�� ��QAni�iG i/lo�,y,����. �,41//S �/�' �ii �_.,_ � <br />� t� ✓ � <br />/ C�/i�/ .; ��4c �.; ��� <br />l / <br />` <br />:'--:---'� „ �; _ . ! j " J <br />A roved4or Constf � � a�e <br />FINAL INSPECTION Dale <br />Approved es Construcled <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Streel <br />Everett, WA 98201 <br />Phone:259�8810 <br />W <br />� <br />� <br />� <br />� <br />O <br />� <br />� <br />O <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The unde�signed owner,'applicanl hereby agrees lo hold and save harm� <br />less ihe Gdy of Ev)rett Irom any and all claims ior damaBes, cosis, <br />e■penses, or cau��s ol ection Ihal mey arise beceuse cl inslallatlon <br />and maintenanfe ol Ihe improvement or other righl�ol�Hey use here�o <br />applied lor a d further agrees to remove same upon notice Irom the <br />City and to t�plac� pubhc propeity damoged fhereby. <br />�J <br />Sign�(tura Applican� � Dale <br />WOpK/1 THORIZED BV THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENiLV PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITV UF'ON ANv STUPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAVS DUFATION. <br />