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Date <br />Aophrahon For <br />PUBLIC WORKS PERMIT <br />Print or Type Only Plan Check No: B 44671 SEPA <br />Applicat.Date: 06/15/94 <br />Job Addre: 501 92ND ST SE <br />Owner: RORVICK MARGARET <br />Tenant: <br />Propoeed UBe: GARAGE <br />Ov,ne, Deec. of Work: <br />POLE BLDG <br />Applicant OFFICE SET JOB SET <br />APPRVD FOR PERMIT: DATE_/_/_ BY <br />Describe Proposed Work <br />Pub.c wdme Peimd • 1-7 <br />Bldg Debt . <br />Pubbe Wbrru Fee S <br />TOM rea <br />Leff &opt Fee P.ud S <br />Babnce DPe S —"0 r <br />ZIP Phnne <br />Phone <br />06/28/94 2916PM <br />Project Address (if known! _ _ NflW44A71 <br />Attach four(4) copies of plans for proposed work - Drava to seal+.ono note the. 'ollowing as applicable: BM $99.00 <br />• Property Lines <br />• Outline and dimensions of all existing and <br />proposed structures on the lot <br />• Existing and proposed utilities <br />• Centerline of street 8 SRCH $4.50 <br />• Indicate North ORWI $20.00 <br />• Show any proposed gradinArlmes $123.50 <br />• Show measurements <br />bY•IZI7 <br />PERMIT CONDITIONS <br />1. All calls for in.t.ectlon shall be made 24 hrs. in advance - phone 259.8810. <br />2. All work shall be performed In accordance with this permit and current City of Everett Design and Construction <br />Standards and Specifications. <br />3. Coll Location Underground Service 48 hrs, before you dig. TOLL FREE NUMBER 1.800-424-5555. <br />Ow✓e- .5t10.L1 <br />q, Pa�c fi-nm pvo��u{� lNeic ad�e o-r rawer Lit in 9.9ht <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />Phone: 259.8810 <br />ACKNOWLEDGEMENT OF CONDITIONS <br />Uj <br />1 <br />ar_ <br />n <br />M <br />W <br />O <br />Bill <br />O <br />The undersoned owner/applicant hereby agrees to hold and save harm- <br />-----� less :he City of Everett from any and all claims for damages. casts <br />expensesor causes of action that may arise because of inslallatior <br />and maintenance of the improvement or other righFol-way use herein <br />' appited for and further agrees to remove same upon notice from the <br />City and to replace public property damaged thereby. <br />Signature of Applicant Date <br />WORK AUTHORIZED BY THIS 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 />