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1 <br /> PuD4c Worb Permd• ��4Ca6 / <br /> Date 4.111 4Q TO POSTING /�_ 5�t26,3x() (el- na 5605) <br /> Application For aids oePl <br /> PUBLIC WORKS PERMIT livbW Ww%s Fee <br /> TPOI fen <br /> y L4,41:,11 Fee Paid <br /> Q .'Y. a•iancs Ow S 2O.DD <br /> y PTlnt oT Type Only <br /> H H 0 Gunter Vierthaler 9327 - 60th Ave W. Mukilteo WA 98275 745-6918 <br /> O ILO Owner Mailing Address City Zip Phom, <br /> y N <br /> hT o Owner _ <br /> H Applicant Mailing Address City Zip Phone <br /> 0 H <br /> gDescribe Proposed Work ennixtrnnt nam Ar nl ex <br /> yy�w r7� <br /> g , 1 ' <br /> y LU <br /> to F3 . B s <br /> N <br /> �fn <br /> Prolecf oess(iiknown) 9 — 76th St SE _ <br /> y Attach four(4)copies of plans for proposed work•Draw to scale and note the following as applicable. <br /> O y • Property Lines • Centerline of street <br /> •Outline and dimensions of all existing and • Indicate North M <br /> proposed structures on the lot • Show any proposed grading changes <br /> • Existing and proposed utilities • Show measurements M <br /> r DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS <br /> 1.All cells for Inspection shall be made 24 hro.In advance•phone 259.8810. rom) <br /> 2.All work shall be performed In accordance with this permit and current City of Everett Design and Construclion <br /> Standards and Specifications. <br /> 3.Cell Location Underground Service 48 firsbelore you dig.TOLL FREE NUMBER 1.800.424.5555. z <br /> 01/31/91 5'39PM 000111115e O <br /> 1� OM6350 Flails <br /> BLDG 1692.00 <br /> PLBO $1..0.00 <br /> MECH $1110 00 O <br /> �MOW SRCH $6.50 <br /> DRVWV $20.00 ^ <br /> #00007118li <br /> WATER $130.00 4 <br /> a00128110 <br /> SEWER $30.00 <br /> ACKNOWLEDl€IT OT$ J5ffIONS <br /> The undersigned owner/appli PrebfpjMW hold and save harm• <br /> less the City of Everett from any and all claims for damages. costs <br /> expenses. or causes of action that may arise because of installation <br /> and maintenance of the Improvement of other right-of-way use hereto <br /> applied for and further agrees to remove same upon notice from the <br /> Approved for C�sll n / Date City and to replace public property damaged thereby. <br /> FINAL INSPECTION Date <br /> Approved as Constructed Signaillire of Applicant Date <br /> eveeleft PUBLIC WORKS DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> I w I 3200 Cedar Street 150 DAYS T DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> U Everett WA 98201 BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY IS <br /> Phone:259.8810 CANCELLED BY THE CITU UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />