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� <br />m <br />Date September 27th, 1988 <br />AppliCation�� <br />PU�LIC WORF� PE�MIT <br />O <br />0 <br />O <br />Print or Type Only ¢ <br />N <br />.-i <br />T <br />Brian and Sherry Shaf�er <br />Harbor h]ountain <br />Describe Proposed Work <br />to <br />Project Rdtlress (i� known) <br />Mailin�d r� <br />\ g <br />: opek,'ti�"s' <br />Nailing Address <br />on <br />O O <br />N CJ <br />� � <br />19818 13th P1 <br />PuOii< Wprks Permil s �� / C/z <br />eiaq. o�a�. , _. <br />rubpp�yo�kSFne �- <br />TomlFee 5 <br />LC55 Appl 'CC Paltl S ��_ <br />eaia�a, o�o g _ �c, Oo <br />�__ <br />SE. Eothell, Wn. 98012 <br />" `-'N Phone <br />11 1/2 Hewitt - 1 Everett, Wash. 98201 <br />tion from site. a� foot <br />i <br />Phone �5-b'-y���� <br />etback will <br />d directiv <br />. __ _ _,_.... uu�a r�l:Ulll <br />Attach four (4) copies of plans for proposed work - Draw W scale and note the following as applica6le: �`}'�' n <br />C Property Lines n �,�"' �'7'=^�< <br />• Outline and dimensions of all existing and � Cen�erline ol street I J� �i t�,� i:�� �,,�-n <br />pioposed struc�ures on the lot � Indicafe Norih <br />• Ezisting and proposed utilities • Show any proposed gr�ding changes <br />i Show measuren;ents <br />PERMIT CONDI110NS <br />1. All calls for insnection �hall be made 24 h-s. in advance - phone 259-8810. <br />2. AII werk shall be pertormed in accordance �»ith this permit end current City of Everelt Design and Construction <br />Standards and Speci(ication:. <br />3. Call Location Underground Service 48 h�s. before you dig. TOLL FREE NUMBER 1-800-424-5555. <br />/. f/.'�JG�q.�,;, �77GnLint�sn.- .30~ oCci��'� ��.," <br />�O �can�.;., y �o � �i c�Oru� !% � J <br />� -G-�c.i�w,� • .z�i��.c� <br />C�Lc� ��,�Q <br />� ��� �� �CA',%G�� O(��� ��LO� COr`� . _ /J �� /J`� _ '!_/L^ J <br />4^ (.lMl(� /YC.CC.4..�y..CQ/ <br />�V-Pyp � � �,i,���J ����.cc.� ,a.e,.� <br />O,�eba -G�e�kL��P,CYd���,�) - <br />�, S-c ��et�a.e�� eC� ���� a��J- ��.c 2� �lce.�.J i <br />-4��{ ���. 4�,,�, a/e�,.c�.�.z�c `z���.-o��-�!'�.C« � � <br />���%v ��l��Cr�'�' �C�c�..�/� <br />� --_.......,.,,,���,.,:�e� <br />everett PUBLIC WORKS DEPARTMENT <br />� 3200 Cedar Street <br />Everett, W� 98201 <br />Phone:<5g-A810 <br />� <br />O <br />ACKNOWLEDGEMENT OF CONUITIONS <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the City of Everetl fran any and all claims for damages, cosis, <br />expenr�;, or causes ef acticn Ihat may arise because of installation <br />and maintenance ol ,he improvement or other righbof-way use herelo <br />applied lor and I�rther agrees ic remove same upon notice trom �he <br />City and to reolace p,iblic property damaged thereby. <br />� s(/� <br />C�i� > Z'� <br />Signature ol Applicantr T� L{��,,.. ��F,�h' Date <br />WORK AUTHORIZED f3Y' i'MS YE'1?M1il� M'U�� g� �Sy��� WITHIN <br />780 DAY� OF DATE PERMIT IS ISSU[D AND TI-IEREAFTER IS TU <br />BE DILIGENTLY PURSUED TO CpMPLETION. THI;i PERMIT MAY BE <br />CANCELLED BY THE CIiY UPpN ANY STOPF'AGE UF WORK ON THIS <br />PROJFCT OVEP 90 DAYS DURATION. <br />