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Date_4-1?-93 <br />�."8��' Jr <br />Applicalion For <br />PUBLIC WORKS PERMIT <br />Tn POSTING -�' - �. <br />Print or Type Only <br />� <br />Pu�lq WarF! Permq • <br />BiepOeo'• 4�ZiS <br />PubL< Wor�� Fee — <br />Tmn rna S <br />le.sAoo�:eevn�e S <br />ee�.,��.�o�P S�' <br />Trigny Corp PO 6ox 769 Mukilteo WA 98275 l53-3158 <br />Owner Maihng AAdress Ci�y 71p Phone - <br />Lakecreat Conetruction 4641 Silvert <br />Meiling Atltlre55 <br />Oescrlbe Pioposed Work new house <br />Projetl Address pt known) <br />Lane Everett WA 9f1203 259-6005 <br />Attach lour �4) copies ol plans lor proposeA work - Draw lo scale and note u�e �ollowing as applicable: <br />• Prcporty Lines <br />• Outline and dimensions ol all existing and <br />pioposed structures on the lol <br />• Existing and proposed u�ilities <br />• Centerllne ol slreet <br />• Intlicale Norih <br />• Show any propused grading changes <br />• Show measuremenls <br />PERMIT CONDITIONS <br />1. All calls lor inspection &hell be made 24 hrs. in advance - phone 258•8610. <br />2. All work shall be perlormed In accordance with thls permit and current City o� Everett Dasign end CanstrucUon <br />Standards and Specilicotions. <br />3. Cell Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800•424•5555. <br />1 <br />Approved as Construcled <br />���{ PUBLIC WOFKS DEPARTMENi <br />�'�r1 3200 Cedar Streef <br />��% ��T Everelt. WA 98201 <br />Phono:259�8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />� <br />� <br />� <br />� <br />O <br />� <br />� <br />O <br />a <br />1hr w�,�rrs�yneA owner/apphcant hereUy ac��eF!s to hnld and save haim� <br />less Ihe Cny ol Evu�ell Irom eny antl all claims br damages, costs. <br />erpenses. cir causes oi action �hat may aiise because ol inslallation <br />and mamlenance of Ihe improvement or other righ��ohway usc heretn <br />applicd lor and lurlher agrees lo remove same upon nclir.e hom tl;e <br />Clty and In replace public property damaged Iheraby <br />C� , � <br />Sig i I Aoplitant Dnte <br />O AUTHORI2E HIS PERMIT MUST BE STARTED NJITHIN <br />DAYS OF DAT � PERMIT IS ISSUED AND TH[REAFTER IS TO <br />BE DILIGENTLV PURSUED TO CUMPLETION. THIS PERMIT MAV �[ <br />CANC[LLED BY 7HE CITV UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVEF 90 DAVS DURATIJN. <br />