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Date �. Ig9'f <br />Application FI <br />PUBLIC WORK$ PERMIT <br />LtJ <br />O <br />Print or Type Only s g g <br />N ti <br />Gary WpispnfpTd <br />Owner M <br />SAME <br />— Applicant Mailinq Address --- City Phone <br />Describe Proposed Work �NC0n <br />Pup4c Worxi Pwrme • ��� <br />61dg DePI • __ —. <br />Pup)¢ Woof Fee <br />Tnlel ree s <br />leas Awl F'e Pmd S <br />eeiencw Duv 6 .r O� <br />0o7-gez Vo //&.3/ <br />Project Address lit known) 30-j$-fiTi�_ _ S' ALU <br />Attach four (4) copies of plans for proposed work - Draw to scale drill note the following as applicable: <br />• Property Lines • Centerline of street <br />• Outline and dimensions of all existing and • Indicate North Cn <br />proposed structures on the lot • Show any Proposed grading changes <br />• Existing and proposed utilities • Show measurements <br />DO NOT WRITE BELOW THIS LINE <br />PERMIT CONDITIONS O <br />1. All calls for inspection shall be made 24 hrs. In advance - phone 259.8810. 7 <br />2. All work shall be performed In accordance with this permit and current City of Everett Des! to and Construction <br />Standards and Specifications <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1.800.424.5555. <br />`i pave //�c �riv�c�ay G 4A"r) file Cify R.9l,f -of w,;y <br />7reorrt the S4cef f(r the Property 6ine , (4Pwrox. ZO <br />Vn <br />O <br />a <br />9 <br />XpPtovetMor Construction etc <br />If <br />17-5 /N <br />FINAL INSPECTION Date <br />Approved as Constructed <br />PUBLIC WORKS DEPARTMENT <br />0 <br />3200 Cedar Street <br />ff <br />Everett, WA 98201 <br />Phone: 259.8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harm. <br />less file 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 or other right-of-way use hereto <br />applied for and further agrees to remove same upon notice from the <br />Gty and to replace public property y amaggd thereby. <br />WOF&ALITHORIZED BY THI PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />