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Applicetbn Fw 8 I Z / Q � . <br /> � PUBLIC WORKS PERMIT Date_� <br /> PUBUC WORKS DEPARTMENT public Works Pertnit M < �� <br /> 3200 CeAa�Street <br /> Everett,WA 98201 259•BB70 Building Permit M <br /> , TYPE OR PRINT OP1LY Publlc Works Fee E�� <br /> � <br /> �A4R�ct U�,,,, �28 ��d,v�r� EvcR�rr 9I�z�/ 7�s— 5')�i'3 <br /> Owner Malling Address City Lp Phone <br /> �-wl.�f �o �,� 'l � � h� r IKT�-er� `1L�3G, 77y - 3�z� — <br /> t Malling Address Ciry Zip Phone <br /> CO u[� ON nlS oUQ�ES <br /> Dexribe Proposed Work r'� � �--� f{�.�r �rT �j } b u ' l� e V � — � <br /> 3 Oo � � D S �� � F c n� � �N h.. <br /> ' , �. <br /> ' ;,, �., � <br /> PROJECT ADDRESS pf known) �z'9 A W��R S�r-' w,� �Zjo �l ✓��S�rJ <br /> Attach tour(1)coplse ol plena la propoeed work•Draw to ncale end note the folbwing B eppllcable: � <br /> 'PnY�erty Llnse �Outline and dimennlons ol all existing and propoeed atructurea on the lot 'Exletinp and proposed utllltlea O <br /> �CentMins ot atrset 'IMicata North Bhow eny proposed r,r�finp chenpea 'Show measuremente .� <br /> I DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS: � <br /> 1.All calla for Inapection shall be made 24 hours in advance- phone 259-8810. O <br /> 2.All work shall be perfortned In accordance with this pertnit and current City of Everett Deslgn end <br /> Conatnrctlon Standards and Speciflcations. <br /> 3.Celi Location Underground Service 48 hrs. before you dig. TOLL FREE NUMlER t-s00-424-6666: H <br /> �� �22fI C� � .Sf 1-eG� f G����i •-�f ��� -�� rvi.c•f - N <br /> r � <br /> �• f',� ll � E�x � Sf ��f� ��r�idc o-� svr��,�.a�l ,..c�' .�'�o�bc;%�� , <br /> , <br /> ,�b ,2-97 `.i:07Fn <br /> N 97LJ <br /> UINkf< <O.W <br /> 1 UtAi. �0.00 <br /> CASH �U.GO <br /> A vh1v5"' <br /> f� <br /> ACKNOWLEOOEMENT OF CONOfT10N3 I <br /> p The undersipned ownm/epplkant hereby apraos to hold end eavs hrmMss <br /> ��l G" _ (J l Ti �� tlw Ciry of Everett hom any and all clalmn for damapea,coete,eMpenees,a I <br /> eaueea�}actlon�het may erlee becauee ot Inetallatbn and rtWntsnancs of <br /> Approvadfa nictbn Dat thelmqovanentaoMerripht-of-weyuseheretoapplbdforandhMherapsss I <br /> to remove eame upo� noNce fiom the City end to replece public property , <br /> i . �o_ 7 .f i damaped theraby. <br /> iwu iNsaEcnon ,1 � oei. <br /> � J ? <br /> i App�oved ae Construeted ;�� , . � � .L ' /i �� //�a�.���I <br /> S�q,uu� �` �- ��. <br /> WORK AUTHORIZED BY 1HIS PERMIT MUS f BE STMTED WIiHIN 1 BO DAYS OF DATE PERMR IS ISSUEU AND THERFJ1FiER IS TO BE DI'J6ENTLV PURSUED Tp <br /> iCO�APLPfION.THIS PERMR MAY BE CANCELLED BY THE CITY UPON ANY STOPPAOE OF WORN ON THIS PROJECT OVER 90 DAY6 DURATION. I <br />