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_ _ - � <br /> ; . <br /> ��m y`7U <br /> D '.L' Date�–�F_Q1 Punncwo�hsPermn� �L��— <br /> " oic� oeo��• � <br /> � W APPlication For —._ <br /> "� " PUBI_IC WCIRh'S P�RMIT '°°°°w°«BFBe <br /> F] H iatalFea 5 <br /> � <br /> K� � Less Apol Fea PaiO 5 ---- <br /> ,�' � 9atanw Oue $��'�<""�- <br /> �t~o� Print or Type Only <br /> HC <br /> O��� FRLD SCFIMIDT PO llOX 956 EVERETT 98206 259-34I2 <br /> H Owner Mailing Fddress City Zip Phone <br /> F Y (] <br /> �y� A%S AL MEEKS 307 73RD ST S�d EVERETT 98203 342-7854 (b-2:30) <br /> t� Applicant .Hailinq Address City Zi Pho e <br /> iy- 3g3-8662 (APTER �:30 ) <br /> $�U H 348-0418 (HOME) <br /> ��w Dee�,cribe Proposed Work tiSPRESSO STAND <br /> O� <br /> .. _ � � , <br /> Proler.t Address�i(known) 5103 EVERGREEN WAY � , <br /> Attach four(4)copies ol plans lor proposed work-Draw lc scale and note the following as applicable: � �� <br /> • Property Lines • Cenlerline ot street ♦A '� <br /> • Outline and dimensions ot all existing and • Indicale North V� <br /> proposed structures on the lot • Show any proposed grading changes � <br /> , • Existing and proposed utilities • Show measurements � � <br /> � <br /> / '��� DO NOT WRITE BEL017 THIS�WE � <br /> I ��� PERMITCONDITIONS � � <br /> ' 1.All calls for inspection shall be made 24 hrs. n advance•phone 2S9•8810. � � <br /> 1 ' ' <br /> 2.All work shall be pedormed in accordonce with ihis permi�and current City of Everett Design and Consiruclion <br /> �� Standards and Specilicatlons. <br /> i � � 3.Call Location Underground Service 48 hrs.belore you dig.TOLL FREE NUMBER 1-B00•424•5555. � i <br /> � <br /> � � ((//L -�LCfiie�f4.+�rm! �lF(�/PGe� ;',��(iTL�� �GCCQ f���t-�tyr G��d/ O � <br /> I _ r/ I <br /> �.� r'v�Lc�c�. C��Lcal-�.z��� Lv�`�l' G� �a��,�..1� y,,. 7?�c.e� <br /> ! .���,�` � �".Ku�%�� .�«��� rn� .�/4, S'c�e. � �w <br /> _I�� I �CQ/�.L'1cGL�� �'J�L �JCG.�L-�r.lf-1/- �/ �, <br /> I� — � U O <br /> i � <br /> I ' '_I <br /> ' ACKNOWLEDGEMENT OF CONDITIONS <br /> ='� <br /> � The undr.rsi9ned owner/applicant hereby agrees lo hold and save harm- <br /> � <br /> less the City of Everett Iwm any and all claims lor damages, costs. , <br /> �1�� A / expenses, or causes ol action thal may arise because oi insta.lation � <br /> i�� /'yL �.,//J/�/ and mainlenance ol the improvement or other ric�hl-of-way use hereto <br /> J�yl Y/ �� applied tqr and further agrees lo removo same upon notice Irom the ' <br /> Approved lor� onstruction /Date City and to replace public properry damaged ihereby. ' <br /> � Ct' C' !�,�.�/� I��23�� <br /> FINAL INSPECTION Dale � � <br /> Approved as Construcled ignalure ol Applicant Date �� <br /> /ArQ.� PUBLICWORKSDEPARTMENT WJRK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200CedarSireet 180 DA'fS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> � G BE DILIGENTLY PURSUED TO COMPLETION. TIiIS PERMIT Iv1AY BE � <br /> . a Everelt,WA 98201 CANC[LLED BY THE CITY UPON ANY STOPPAGE OF N'ORfC ON THIS <br /> Phone:259�8810 PROJECT OVER 90 DAYS DURAiION. <br /> i . <br />