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Date-,2_—, -yf 1C POSTING ¢Welk$Pal.it 0 1 27T <br /> PU�/�y�(7���•�y�t ��� 3 � � De01 _ <br /> V �.l 11I1'Ir.�M1Iyr_^'�f�a�./\yylFRMIT PuoucralF Fee <br /> FEB 13 1995 Leu APPL Fee Polo S <br /> Print or Type Only •••••• --.... .. . <br /> aalance Due S <br /> CITY OF EVERETT <br /> Bid . Permit Counter <br /> Ae k6 &� IIAZ frur�oa AMS &idie11 &7Nuv 174// 9Lf0/Z al-OC,6 r <br /> Owner Mailing Address ICity Zip Phone <br /> Les lJea, Zr4,e Pa likiY /" Glk. s*tleNs 9843J'- :?.Z 76 <br /> Applicant ..M,CCailing Address City �Ziip Phone <br /> Describe Proposed / IWyyo��rk T t.,da/I S)init-& a, J_ r �i.!/1ieMs- <br /> LU <br /> Project Address(if known) 13 <br /> Attach lour(4) copies of plans for proposed work- Draw to scale and note the following as applicable: <br /> • Property Lines • Centerline of street /w <br /> • Outline and dimensions of all existing and • Indicate North V, <br /> proposed structures on the lot • Show any proposed grading changes <br /> • Ex-sting and proposed utilities • Show measurements <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <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 /> 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBEn 1.800.424.5555. <br /> Iwo <br /> 0 <br /> a <br /> She <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harm- <br /> less the City of Everett from any and all claims for damages, costs. <br /> expenses, or causes of action that may arise because of Installation <br /> and maintenance of the improvement or other right•ol-way use hereto <br /> applied for and further agrees to remove same upon notice from the <br /> Approve for Co ruction - Tale City and to replace public property damaged thereby. <br /> FINAL INSPECTION Date -f—y.C.ilJf.Cr. <br /> Approved as Constructed Signature of Applicant Dale <br /> PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200 Cedar Street 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett,WA 98201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone:2598810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />