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+oplkallon for <br /> PUBLIC V. JRKS PERMIT Date <br /> PUBLIC WORKS DEPARTMENT Public Works Permit M <br /> 3200 Cedar Street <br /> Evc WA 08201 259-8810 Bullding Permit N_ <br /> TYPE OR PRINT ONLY Public Works Fee E <br /> Plan Check No: B 54930 SEPA <br /> Applicat.Datet 04/24/97 <br /> Owner Job Address: 2119 61ST ST SE Phone <br /> Ownor: PALMER MIKE <br /> Tenint: <br /> Propoaed Use: GARAGE <br /> Applicant Desc. of Work: Phone <br /> NEW POLE BLDG (EXISTING TO BE DEMO'D) <br /> Describe Proposed Work OFFICC SET ___JOB SET Uj <br /> - AFPROVED FOR PERMIT: DATE_/_/_ BY_ __------- <br /> tlllllii� <br /> PROJECT ADDRESS(if known) ---- -- M <br /> Attach four(4)copies of plans for proposed work-Draw to scale and note the following if applicable: O <br /> •Property Unes 'Outline and dlmenslons of all existing and proposed structures on the lot •Existing and proposed utilities <br /> 'Centerline of street 'indicate North 'Show any proposed grading changes •Show measurements <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS: z <br /> 1. All calls for inspection shall be made 24 hours In advance-phone 259-8810. O <br /> 2. All work shall be performed in accordance with this permit and current City of Everett Design and <br /> Construction Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800.424-5555. //�/� <br /> V♦ <br /> y � 0 <br /> I <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harmless <br /> the City of Everett from any and all claims for damages,costs,expenses,or <br /> ruvod for Construction Date causes of action that may arise because of installation and maintenance of <br /> A <br /> PP the improvement or other right-of-way use hereto applied for and further agrees <br /> to remove same upon notice from the City and to replace public property <br /> damaged thereby. <br /> FINAL INSPECTION Dale <br /> Approved as Constructed <br /> Signature of Applicant Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLETION.THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />