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j�l►K � � _ �� y - ,��yd <br /> PUBLIC 1JVw��P��RMIT ��•�is 9� _ <br /> � PUBLIC WORKS OEPARTMENT�• Public WorW Pen�tt• <br /> 3200 Cadar Street "� <br /> T C P 0 ST I N G �'�H 1 � ���n,WA BB201 259•8870, eulldinq Permtt N_ <br /> i�J <br /> TYPE OR PRIN70NLY � � ; ,i „ �... , <br /> Publk WaW Fae S � <br /> ':�: '.. �_ � i_ , J �W. � <br /> �f2�z'��i�,� `�"r��• :l 2�G � ..��e.� I��i <br /> .,, <br /> Ow�er Mallinq Add�eas � ' -.. City Lp Phone <br /> O�T� tn � � 'S `� <br /> t <br /> Applicant MallinpA.Qdres��. ' �i. i_; ���Y LP PhO^� <br /> . :_. � ... �; -: zr <br /> Describe Proposed Work ���""'�T ��3 ��fl � �� W <br /> 'v�'r`-"— � <br /> _ ��/- z - 98 � <br /> PROJECT ADDRESS pf known) � V ^"��Q-''� `n _ M <br /> P.tlach fou�(4)copies ol plana fw proposed work•Drew to scele end note tha followinp M epplieable: W <br /> 'Properry Linee 'Outlins and dimenslona ol ell exlatinp enc'�xoposed sWctures on tM bt 'Ecistinp end propoxd utllltles O <br /> �Canterflne of atroet •Irdieats NoAh 51ww any propoeed flradiny chanpss •Show meaeursments � <br /> DO NOT WRITE BELOW THIS UNE � <br /> �RMIT CONDITIONS: <br /> All calls for inspectlon shall be made 24 haurn lii advance-phone?59-8810. O <br /> 2.All work ahall be performed in accordance with this pertnk and curtent City of Everett Deslgn and <br /> Con�truction Standerds and Speciflcatlons. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-6666. � <br /> t�. I°..ar a77�,� �/ur- (/� <br /> r 6� � �L <br /> ,5 /,�,, ' �,,,,i S ft� 3 •� Z � �r� � r O <br /> /.� ' a <br /> Co. (2) a� s-w�� �s' � L'� f�`� �oZ �l � �4� �� <br /> 7. �Z� S��� S.u�-'r Sfv6s � C��' S�-d , Gpl� (oZ��� <br /> � Su Y\/�/►'��'J Ytil'J i� d �'r*'— l n�/�/l�HvY� G t <br /> ! Q <br /> c/rt c.4.� t�i <br /> / <br /> ACYNOWLEDOEMENT OF CONDITIOPIS <br /> ihe undaniqned o�mer/appliunt hmaby apreaa to M1d end aeve harmbsn <br /> �' / tha Cly ol�•.�aratt fran any end all clelma far damagee.coete.axpensas,a <br /> ��ye`� /-� auses of eetla�thel resy nrix beeauee ol Installalbn end malntananea of <br /> !�p forCo�eu ��• � theim{xovementaotherrfphFof-w.yweheretoepplbdforendNrtherap�esa <br /> to ,emov eame upon noGce hom the Gity and ro replaee publlc proFeAY <br /> ;� ^-� damaged hs <br /> FI INSPECTION Date �{ �/ <br /> /lppmved as Conslmcted � 1 � { <br /> SignaWre ot licnnt Data <br /> WORK AUTHORIZED BV THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERM SSUED N1D THEREAFfER IS TO BE DILIOENTLY PURSUED TO <br /> COMPLEf10N.THiS PERMIT MAY BE CANCELLED BY THE CIiY UPQN ANY STOPPAGE 0 ORK ON T411S PROJECT OVER 90 DAYS WMTION. <br />