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Date �-�9-Q2 ��� <br />�� ��� APPIi or <br />LIC �RKS P�RMIT . <br />�a��� .........s � T�l POSTING �-1� -9, <br />� <br />Print or Type Only G,O�` a�9 V� v�a o� <br />Washington Natural Gas <br />815 Mercer St <br />f:7i1 <br />PupLc Wm�� parmn • = 1 Z ��O 3/ <br />A��U OeO� . 37093 � ___ <br />PubL� Worb pee q/� <br />Totel iee s _�Q / T �� �—� <br />leaf RpO� �ae Pe�a s <br />B�IenceDue s 0 "�.� � <br />Dykeman Architects 1602 Hewitt Ave. 1f400 Everett 98201 259-3161 <br />Applicant lAailing Address Cily Zip <br />DescribePronosedwork new constru��tion/office bld�_ <br />Proiecl Address (il known) <br />1122 75th St <br />Aflach fou� (4) cepies of plans lor proposed worh • Draw to scale and note ihe loll�wing as apP��cable: <br />• Prope�ly Lines <br />• Oulline and dimensions ol all e�isting and <br />proposed slruclures on the lot <br />• EMisling and proposed utilities <br />• Cenledine ol street <br />• Indicate North <br />• Show any proposed grading changes <br />• Show measuremenis <br />PhOnc <br />PERMIT CONDITIONS <br />1. All calls lor Inapaction ahall be made 24 nrs. In advence - phone 259•8810. <br />2. All work shall ba pe�formed In accordance wilh Ihis permit and current :,Ity ol Everetl Des�gn and Conslructlon <br />Standerds and Specllicatlons. <br />3. Cell Locetion Underground Service 48 hrs. belore y�i� dig. TOLL FREE NUMBER 1•800-424•5555. <br />� �r <br />����.�/,s a���� <br />� / <br />FINAL INSPECTION `� <br />App�oved es Construcled <br />�A�I� PUBLIC WORHS DEPARTMEI�T <br />� 3200 Cedar Slree� <br />� Evere!C WA 98201 <br />Phone�259•BB10 <br />ACKNOWLEDG[MENT OF CONDITIONS <br />W <br />� <br />� <br />H <br />c/i <br />O <br />a <br />The undersigned owner/applicant hereby agrees to hold and save harm� <br />Iess Ihe Gty of Everett I�om any and all claims for damages, cos�s. <br />expenses, or causes ol action thal may erise because ol Installation <br />and mamlenance ol Ihe improvemAnt or other riqhf�ol•way use herelo <br />applieA lor and lur�her agrees lo iamove same upon notice Irom ihe <br />Cqy an to replace pubhc property damaged thereby. <br />(,�'� ' �'L� / -ZC- `ii <br />Signal re ol ppLc nt Date <br />WORK AUTH RI2ED BY TfiIS PERMIT MUST BE S?ARTED WITHIN <br />180 DAYS OF DATE PERMIi IS ISSUED ANO iHEREAFTER IS TO <br />BE DILIGENTLV PURSUED TO COMPLETION. iH15 PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WGRK ON THIS <br />PROJECT OVER 90 DAVS DURATION. <br />