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� <br />TYPC O'a PRINT ONLY <br />Appbw�ion For <br />PUBLIC WORK � PEa�MIT <br />PUBLIC WORKS DEPAHTMENT <br />3200 Cedar Streo� <br />Everott, WA 98201 259�tl810 <br />` °�StING FEB 0 g igg9 <br />Kvernnio Const 16212 Bothell Way SE <br />UH�• � ^ Mailino Adtlress <br />Describe Proposed Work <br />Address <br />new house - Basic 1245 <br />� <br />oaie__ � 10-08-97 ,�� <br />-�-- - /n <br />Public Wor� Permit M_��. �' W <br />ur <br />B�iltling P�it N ___ 56721 <br />� o3P�bI�CV�rksFeeE_ L-r/ __.._---_---- <br />8'i� �J m V O If) � <br />• CJ .t <br />c�6tl�lr�i�'�-°�11 = <br />City Zip'� "' ¢ <br />r <br />('��(y'!� -.� � w i.ri :1 � <br />a 2'n 3����'..� sUS�� <br />PROJECT ADDkESS (if known) 2225 75th St SE Lot a SP 112-97 <br />Attach four (4) copies oi plans lor proposed work - Draw to scale and note the lollowing If rpplicable: <br />•Propeny Lines 'Outline and dimensions ol all exisling and Froposed structures on �he lol •Exlsting and pmposed utilities <br />•CenlerGne of street •Indicate North •Show ony proposed grading changes •Show measurements <br />PERMIT CONDITIONS: <br />1. All calls lor 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 and <br />Construction Standards and Specitications. <br />�. Call Location Underground Service 48 hrs. betore you dig. TOLL FREE NUMBER 1-800-424-5555. <br />� In.t:ill nu nililh-ihun �n�nch Innll ;i. ���•r Sc� ��uu i-� G?;ind I�ieum tmd'falil:� i-' ? o� U�c cdc <br />i��inn�atcr ��I;msic� mrid �I:mu.�l (copv's �Isy�lcd lo Iliia p�•nuil) 'llic udillrfWun trruch +h�dl b�� no <br />, I�,, i tlr,m S I, rl lu anc up .I�ipr ��ro�r. i t� linr i,r �nund.dion nor ciotii•r ��imi 10 I: ; t lo ,im Jo�cu,lul <br />� �, i�� Iw. ni li�un�l:ih��u t':dl I'ublic \4';»1;� li�r;ui m..•��rchon ��rinrto crnenqe li:�nchc�. <br />� :un��l Ilu::;Uuclm:�h�i;�y�piu� ZZ�Fq.t'1.ofinipr;•rcimi.roc�f.u..�. Ilirnloic <br />�1 �1 r;Ul� C�fIKti U� (OUTAi' .cflq[l I'; :I��nllilli•i� 811(� l�li' III�I��f8110�t U�:91c�1 I> CUII�IIIcIJt� <br />�f'r_ �l_�L� �inJ t/►. n•i�/c. fiom hil,li :-� � Ihc trencli .hnuld h;� � L. /. un ,. <br />li � owhh�m, in �lir licid � aiy ti mu Ihos�� iu Ilic ",�mq�l: -;ul�ii� � acrni dnivl� <br />u.im.� tli:• ;ibu� ,• ai.�nUum�d I;ihlr ;w a uwJ.• <br />� <br />O <br />��/� <br />V♦ <br />O <br />a <br />ACKNOWLEDGEMENi OF CONDITIONS <br />The underslgned owner/applicant hereby ag�aes to hoid and save harmtess <br />Iha City ol Everetl Irom any and all claims lor damages, cosis, eKpenses, or <br />causes ol actlon �hat may anse because ol installalion and mainlenance ol <br />the improvement or other right-ol-way use hereto applied for end further agrees <br />to remove same upun notice Irom the City and lo reptace public property <br />damaged Ihereby. <br />�-�,r��—..�� j �ls-�v 9 7 <br />Sig we ol Applica t Date <br />WORK AUTHORIZED BV THIS PERMII MUST BE STARTE� WIiHIN 1B0 DAYS l�F DATE PERMIT IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO <br />COMPLEiION. THIS PERMIT MAY BE CANCELLED BY THF C17V UPON ANV STOPPAGE OF WORK ON TFiIS PRQIECT OVER 90 DAVS DUNATION. <br />