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- , --. .. - . , —,�.v.,.._.... :.�::,..�..,. ., ..._._...,_. ,.;�._________ -�-:Y.lr'1',��� <br /> (�'�/J''� r. . n� , �j <br /> � �8�9�J�-�y � ' � . VUEbcWarY�Pe �� G�� i <br /> . APGllcetion For � eina o.o�.. . — � <br /> � ��, PUBUC WORKS PERMIT PuGP.cwarw��ea — I <br /> Tolnl Fea �— <br /> y r <br /> laf��ppl Fee Psitl / <br /> ��j <br /> � B�i�nce Oue � L�� <br /> �rint or Type Only <br /> ���1�� �'�i � I����'-�=s-� �'i.�'�ff- q�y �3-��25 <br /> Owner Mai�ing�tldress COy LD Phone <br /> � ppP���e�� Malling Address City Lp Phnne <br /> � <br /> Describe Pioposed Work � � <br /> ProJectAddreeslilknownl � ���-� •q�/GC� LN. � <br /> � <br /> Att�cR four(4)coD�es of Dlens for propoaed work•Drew to scale and note Ihe I011owinB as applicable: - � <br /> • Property Llnee • Centedine of etreet <br /> •Outline and dlmensione of all e�istinp and • Indicale North y �� <br /> proDoeed slructurea on the lot ., • Show any prapoaed gredinp chanpea i <br /> •Exfalinq end proposed uBl�diea • Show meaauremente � ' <br /> 1 <br /> L i <br /> PERMITCONDITIONS O _ <br /> 1.All calb for In�pecllon ehNl be made 24 Aro.In edvance•phone Z6��10. � <br /> 2.All worlc�MII bs puAormed In�xordance with thls permit end curcent Clty ol Everott Oeslpn�nE Con�tructlon <br /> 8t�ntlud��nd Spsclfkatlona <br /> 3.C�Y lOc�tlan Unrlerqround Service 48 hro.before you d�p.TOLL f11E!NUM�l111�OO1Z1�8868. � <br /> i. <br /> � O <br /> n� <br /> � <br /> , O <br /> � <br /> /`� ACKNOWLEDGEMENT OF CONDITIONS <br /> n� The undersigned owner/epplicant hereby aprees to hold and sevo harm• <br /> less the City ol Everett Irom eny end all claims lor demapes, coeta <br /> ��� �J/� e■pensns. or causes of ectlon Ihet muy ariee becauee ol Inetallatlon <br /> �7�I(/L.b �O'�i��- B —��07 end n��.ntenance af Ihe improvement or other�ipht•al•way use hereto <br /> � ypplled lor and lurther agrees lo remove same upon notice hom the <br /> Approved fo�Construction � � �ale Cit to replece pubGc property demaged ihereby. <br /> i <br /> FINAL INSPECYION Dete � � /�_Z� � <br /> Approved ae Conelrucled Sig� ur o pplicant Date <br /> W�IM( AUTHORIZED BY THIS PEFMIT UST BE STARTED WITHIN <br /> everett PUBLICWf1RK5UEPARTMENT 1B0 DAYS OF DATE PERMIT IS ISSUED AND ?HEREAFTER IS TO <br /> � 3200Cedar9treet BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY RE <br /> Everelt,WA 98201 ;ANCELLED BY TI1E CITV UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:26&8810 PROJECT OVER 90 DAVS DURATION. � <br />