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� <br />TYPE OR PRINT ONLY <br />Owner <br />Applicant <br />Wiion fur <br />PUBLIC WJRKS PERMIT <br />PUBLIC WOFKS OEPARTMENT <br />3200 Cetlar S' eet <br />Everett, WA98201 259-8870 <br />Plan Check Nos B 54705 <br />Applicat.Date: 04/02/97 <br />Job Addreees 1718 ysTx sT sE <br />Owners KORTEKAAS IAENE <br />Tenantt <br />Propoeed Uees CARPOAT <br />Deec. of Work: <br />CARPOAT <br />� . .. <br />Dale _____ <br />Public Works Permit a <br />Builtling Permit N __ <br />o�.wr. ur,..ks Fee $ <br />SEPA <br />DCSCribB PropOSBd WOfk _ OFFICE SET JOB SET <br />APPROVED FOR PERMITs DATE_/__/_ gy <br />PROJECT ADDRESS (If known) <br />Phone <br />Phona <br />Attach four (4) copies of plans for prc �satl work - Draw to scale and note the followin3 if applicable: <br />•Property Llnes bu�line and tlimensions ol all axisting and proposed structures on the lot •Existinp and proposed utllitles <br />�Centerllne of street •Intllcate Nonh �Show any proposed grading changes •Show measurements <br />- -.-�• ••••••��+��v�• 1111JLIIVC <br />ERMIT CONDITIONS: <br />1. All calls for inspection shall be made 24 hours in advance - phona 259-8810. <br />2. All work shall be performsd in accordance with this permit and current Clry of Everett Design end <br />Constructlon Stanoards and Specifications. <br />3. Call Location Underground Service 4B hrs. before you dig, TOLL FREE NUMBER 1-800-424-555b, <br />i����� i ���1, I��- I�l���� ��� �t ����,.4� ����v� ��. <br />Approved for Constructlon Date <br />FINAL INSPECTION Date <br />Approved es Canatructed <br />� <br />O <br />/i� <br />V♦ <br />O <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agraea to hold and eave harmlass <br />the City of Everett from eny and all claima lor damagee, coets, eMpenses, or <br />causes of actlon thet may arise because of Instelletlon end malntenante of <br />Ihn improvemxnt or other rlght-of-way use hereto applied for end NAher agrees <br />to remova same upon notica Irom the City and to repleee public property <br />demaged thereby. <br />Signalure ol Appllcant Date <br />WORK AUTHORIZED BY THIS PERMI'f MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT �S ISSUED AND THEREAFfER IS TO BE DILIGEM .Y PURSUED TO <br />COMPLETION. THIS PERMIT MAY BE :ANCELLED BV THE CI1Y UPON ANV STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAVS DURATION. <br />