Laserfiche WebLink
C. Z0 !s- <br />Appbcalinn For <br />PUBLIC WORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 259.8810- W9 <br />T POSTING — <br />I. . <br />TYPE OR PRINT ONLY <br />Loren Dorrah 2820 B Lincoln <br />2t99 <br />98036 <br />Date I-22-97 <br />Public Works Permit If _ C7- i2JZ <br />Building Permit A _ 54022 <br />Public Works Fee S <br />787-6700 <br />rnone <br />Curt Johnson 337-4733 <br />Applicant Mailing Address City Zip Phone <br />Describe Proposed Work new hawse <br />PROJECT ADDRESS (if known) <br />C//f ✓ 1 A* 6 0I 1 ill- Lot <br />W <br />I— <br />Attach four (4) copies of ptans for proposed work - Draw to scale and note the following if applicable: <br />•Property Lines "Outline and dimensions of all existing and proposed structures on the lot •Existing and proposed utilities <br />•Centerline of stree' •Indicate North 'Show any proposed grading changes 'Show measurements <br />PERMIT CONDITIONS: <br />1. All calls for Inspection shall be made 24 hours in advance - phone 259.8810. <br />2. All work shall be performed in accordance with this permit and current City of Everett Design end <br />Construction Standards and Specificatiins. <br />3. Call Location Underground Service 48 his. before you dig. TOLL FR?E NUMBER 1-800-424-5555. <br />oi• All VGhi Gles gufv po7 . <br />02/04/97 9:04AM <br />/ <br />b lv0(C O i' /t/We <br />D054022 <br />EL <br />ELDG f1034.50 <br />PLBG $154,00 <br />MECH 111i120.00 <br />SRCHRG $6.30 <br />DRIVWY $20.00 <br />#00009259 <br />WATER 1100. m <br />#00030970 <br />SEWER s70.00 <br />SVSCEV 11.884.00 <br />hIDIII $730.00 <br />CHECH 4774-9.00 <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 />causes of action that may wise because of Installation and maintenance of <br />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 />Signature of Applic 11 Date <br />T IS ISSUED AND THEREAFTER IS TO BE <br />CWORK OMPLETION.THIS D PERMIT MAY BE CANCELLED BY THE CITY ED (N 180 DAYS OF DATE UPON ANY STOPPAGE OF WI ORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />DILIGENTLY PURSUED TO <br />BY THIS PERMIT MUST BE RATION. <br />