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�fT/�' —ZCI—s PuM,cwe,M.Ph,ed0 <br /> Date 1122 2/9/91 TO PMTI IY V_ Brno Not a 9113°^ in <br /> Application For <br /> y PUBLIC WORKS PERMIT PubTCWpreefes tt <br /> Tc W Fee <br /> p x Lan Appi Fee Pod 6 <br /> H Balance Due 'O <br /> aHxaSy PrirI or Type Only <br /> M x 3[ <br /> y H <br /> 2721 - 116th St: Everett WA 98208 337-7153 _ <br /> O x0 Great N.W. Const. _-- City 7,P Pnone <br /> NH Owner MaINn,1 nddress <br /> OO Owner iA a•linq!,]diens' i— CdY ZiP Phone <br /> HH Applicant <br /> HtZI8 <br /> a` qqn rhna rnrL�GJ _ Family o..aldp cp <br /> yX H 3 Describe Proposed Work <br /> [^ H[xr1 <br /> to UJ <br /> H <br /> t7 N <br /> Pit- <br /> xi:XX % A <br /> FM <br /> Project Address known) <br /> Z. aaaae <br /> H O IA Attach four(4)copies of plans for proposed work• Draw to scale and nota the following as applicable. <br /> 9 Property Lines • Centerline of street <br /> • Outline and dimensicns of all existing and • Indicate North <br /> • Show any proposed grading changes <br /> proposed structures on the lot <br /> • Show measurements M <br /> • Existing and proposed utilities W <br /> / DO NOT WRITE BELOW THIS LINE 0 <br /> PERMIT CONDITIONS l`aaaaa <br /> .. <br /> 1.All calls for Inspection shall be made 24 hrs.in advance•phone 259.8810. <br /> 2.All work shall be performed In accordance with this permit and current City of Everett Design and Construction <br /> Standards and Specifications. <br /> "See, 3.Call Location Underground Service 48 hra.before you dig.TOLL FREE NUMUER 1.800.424.5555. <br /> f ' O <br /> ai keep c1 54recrs <br /> C.teah at eLi �iw v� . LL <br /> a <br /> =I i ACKNOWLEDGEMENT OF CONDITIONS <br /> The u the <br /> of owner t from <br /> eenl hereby agrees to hold and save harms <br /> jean the Cily of Everett Irom any and all claims for damages, coats. <br /> expenses, or causes of action that may arise because of Installation <br /> ' • r - ' ••'�77 and maintenance of the improvement or v other rightpoo notice <br /> use hereto <br /> �L-2� <br /> applied for and further agrees to remove same upon notice Irom the <br /> Approved lot Construction Date City and to replace public properly damaged thereby <br /> –� Data <br /> FINAL INSPECTION Signals, of Appllca Dale <br /> Approved as Constructed WORK AUTHORIZ• BY THIS PERtHUT MUST BE STARTED WITHIN <br /> PUBLIC WORKS DEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TC <br /> 3200 Cedar Street BE DILIGENTLY PURSUED TO COMPLETION,THIS PERMIT MAY BE <br /> Everett WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:2698810 PROJECT OVER 90 DAYS DURATION. <br />