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r—�--�--_...�._. _.._ .. ... _ . . _.. _ _ .. _ . .._ . . . _ ._ ._... - . <br /> .. _ ,. __ . ._. <br /> i <br /> 5/26/93 P�bLtWork�Permit• � �` • <br /> Date <br /> � eiao.oeo�.• <br /> Application For <br /> - PUBLIC WORKS PERMIT PuOTotalFeeFee S <br /> LessAppl.FeePaia s �7 / <br /> BaianceDue S,L� � '�G�- <br /> Print or Type Only <br /> Groun Health Cooperative 521 wall St Seattle IIA 98121 448-2355 <br /> Owner Mai4ing Atldress Ciry Zip Phone <br /> Joe Neuenschwander 448-2355 <br /> Applicant Mailing Address City Zip Phone <br /> Describe Proposed Work _ Traff.ic control for construction <br /> W I <br /> Project Address(il known) 2930 Maple St � <br /> �� Attach four(4) copies ol plans for proposed work- Draw to scale and note tne following as applicable: ' � <br /> • Property Lines • Centerline of street � <br /> • Outline and dimensions of all existing and • Indicate North <br /> proposed structures on the lot � Show any proposed grading chan8es <br /> i Existing and proposed utilities • Show measurements � <br /> � DO NO WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS +�`� <br /> : 1.All calls for inspectbn shall be mede 24 hr8.jp:ativ6nce•phone 259•8810. � <br /> ' 2.All work shall be performed in accordance wttA this permit and curcent City of Everett Design end Constructlon <br /> ' Standerda and Specifications. <br /> 3.Cell Location Underground Service 4B hrs.betore you dig.TOLL FREE NUMBER 1•800�4245555. � <br /> 4. Work shall be done per plan approved by Everett Public 4'orks on 5/24/93 O <br /> 5. Any dnmage to the new asphalt ovorlay on Maple St sl�all be repaired,!replaced <br /> by the developar. � <br /> � <br /> � � a - <br /> a� � D <br /> y �g 1993 <br /> MA <br /> ACKNOW LEDGEMENT,QF.GTOTNDITIONS <br /> � The undersigned owcier/a�11��Ft���}�4grCes to hold and save harm- <br /> j less the Ciry o� Eve�A.T,t'b'nrAfY3py(�11��0(Claims for damages, wsts, <br /> expenses, or causes o�w�e�Mat may arise because of inyallation <br /> � and maintenance of the improvement or other right-of•way use hereto <br /> � _��� aPPlied br and fuAher a9rees to remove same uPon notice from the <br /> Approved for Construction a�e City and to replace pub�ic property damaged thereby. <br /> � . � <br /> Date �:�:/f: .�� S�L6'•�a` <br /> FINAL INSPECTION Date <br /> Approved as Constructed S� nat e of Applicant <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> i , � PUBLICWORKSDEPARTMENT 180 OAYS OF DATE PERMIT IS ISSUED A:VD THEREAFTER IS TO <br /> 3200CedarStreet BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Everet4 WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAC:E OF WORK ON THIS <br /> i Phone:259•8810 pROJECT OVER 90 DAYS DURATION. <br /> I� <br />