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-- - ----_. _-- - -- <br /> �ate � ,"^ , PoEtic Wo�k�Pnm�__� <br /> ApDllcefion For eiao.o.o�-• <br /> PUBLIC WORKS PERMIT °�°:a,:Fs�F�� . <br /> L�n�DD�Fa�P�iO / <br /> Print or Type Only e.�.�.o�. s <br /> � I�t��d �/A�1 � �S� -��7/J�- <br /> Ow�i er MelNnp Atltlresa City Zip Fhone <br /> Applicant Malting Addreae City Zlp Phone <br /> Deecdbe Propoead Work ` �'4���/ I <br /> W <br /> ProJect Add�ese(If known) L� �f d � <br /> Attach four(4)copies ol Dlans for proposed work•Oraw to scele and note the Iollowing ea epplicable: � <br /> • Propsrty Linas • Centerllne ol slreet � <br /> •Outline end tlimenslons of all exietinp and • Indicate North <br /> proposed structutea on the lot • Show any propo6ed predinp chengea <br /> • Exlstinp and proposed utilitles � • Show measuremente � <br /> N W I EL I LIN O <br /> PERMIT CONDITIONS <br /> 1. All calle for Inspecllon ehall be mede 24 h�d In advence•phone Z59•88/S. � <br /> 2. All work shall ba DsAormed In eccordance with thla permit and currenl Clty ol Everett Deslpn and ConStructlon <br /> Standards end 3pecificatlana <br /> �3. Gall Lowtlon Unde�pround Service 48 hre before you dlp.TOLL fREE NUMBER 1•800�424•56bb. � <br /> �!/BL,/G G!/o.P.�S �E.e/�T �tJor .c�EqlJi.CE�C7 O <br /> /D /� � <br /> �� � <br /> 0 <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applfcant hereby apreee to hold end seve harm- <br /> less the Clly of Everetl Irom eny end all clalme lor damagea costs, <br /> expenaes, or ceusea ol actlon that may arlee beceuee ol Inatelletlon <br /> and malntenence ol the Improvement or other �Ight•of•way uae heralo <br /> applled lor and further agreea lo remove seme uoon notice Irom Ihe <br /> � Approved lor Conelruction Dale Clly end to replace public p�operty damaged thereby. <br /> FINAL INSPECTION Dele <br /> Approved as Conatructed SfBnature ol Applicent Dete <br /> everett PUBLIC WORKS DEPARTMENT WORK AUTHORI2ED BY THIS PERMIT MUST BE STAHTED WIiHIN <br /> � 3200 Ceder Streel iB0 DAYS OF DATE PERMIT IS ISSUED ANO THEREAFTER IS TO <br /> Everett,WA 98201 BE DILIQENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Phone:259•8815 CANCELLED BY THE Clri UPON ANY STOPPA6�OF WORK ON THIS <br /> PROJECT OVER 90 DAVS DURATION. <br />