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�� -\ � i <br />oei@ `,(�_O I <br />AppLcalicn Fo� <br />PUBLIC W�IRKS PERMIT <br />Print or Type Oni, <br />�� <br />Uwner � _ ) <br /><- <br />� _ , <br />Apphcanl <br />Describe Praposed Work <br />r'� <br />Mailing Addre55 ` <br />Project Address (il koown) � �._�_ <br />C��tuc Wo•k� Parmil • � !�. _ v <br />H��fp OxDI • �_ '� _��II � . <br />,.,.,� . W�,�.�,.A ------- - _ - <br />tmn� rax 6 _. __-- <br />ies: �nn� F.c vam S — <br />! '_u _ <br />Hainni r fAir S � _ <br />,, {f , � <br />�:�t�' �' �"� � I ' <br />c�iv t��, <br />l4 � '1�1�i ,=:� -� ; <br />��--" <br />Cii)' Z.P — <br />L_- <br />Atlach four 14) copies of plans br proposed work � Draw� to scale and notr, the lollowing as apphwhle�. <br />O Properl� Linas • Cenlerlme ot sireet <br />• Outline and dimensions ol all e�isting and • Indicale North <br />proposed slructures on the lol • Show any proposed gradiny changcs <br />• ExisUng and proposed utilities • Show measurements <br />Phone <br />Phone <br />PERMIT GONDITIONS <br />1. All calls for Inapection shell be metle 24 hr.s. in advance • phone 259•8810. <br />2. All work ahall be pedormed in accordance with this permit and wrrent City ol Everett Design end Construction <br />Stendarda end Specificetions. <br />3. Call Locatlon Underground Service 4B hrs. before you dig. TOLL FREE NUM9EA 1•800•424•5555. <br />r, �2[?r -�� t'fi+�l� IC1 e'i ii . ii. ( l�=Y-r� .�C�<� �. [��,.�tc, �:�f � z <br />/ <br />�Z�ry�ar, �•�. �X� ja (� �c)�,-y c✓:.Z`�/ //-7–.5�% <br />-y/ � / . �� , <br />.] .//Le �/J.,a.Ce.P�e��w7/G^L..`7r.e.y, .C.>..Cc� ��'7-tdG�. �c-. <br />/ '/� i• / ��'.. <br />�- / .�� � �r < <br />C�a/-�'�7�lt-�'�-CG'. �I('!�1l,:.:�tr � K� L- L<.Y✓��:- <br />/ , J � / L <br />.t/�yE'�� ' Lnu .? 7c° .l.tO�ted� � �1a c2r`�. -�� >�� �i <br />�-1 c r_ c c,T� �- - <br />� � r/ �l �c �.J / /� <br />,L�tr l"7 � i!'CJ. �.J/ ��7 / �i�((.�. CJ 4a !llC ( `.'-��/�^�.�%� . <br />0 <br />i <br />FINAL INSF'ECTION <br />Approved as Conslructed <br />everell PUBUCWORKSDEPARTMENT <br />� 3200 Cetlar Slreet <br />Everett WA 98201 <br />Phone�.259-8810 <br />0 <br />7� � <br />oa�e <br />� <br />W <br />� <br />w <br />� <br />� <br />O <br />'�w <br />_I <br />� <br />a <br />Af;KNOWLE�GEMENT OF �:�NDi?ION� <br />The underslgned owner/applicant hereby aqrees lo hold and save harm� <br />less Ihe Cily of Everett Irom any and all claims fcr damagec. coste. <br />expenses. u� causes cf action ihat may arisn because of installahon <br />and maintenance o� �he impiovement or CIhP.f nghl•oDwOy use here�u <br />apphc r and �ur�her ac�rees to remove sarne upon notice from the <br />Gty id o repla , pubhc p�opn,rty damaged Ihereby. <br />( . � �Cl:c �l� — / �"� c <br />SignaWre ol AVP��canl Dale <br />VlORK AUTHORIZED BV THIS PERMIT MUST BE STARTED WITHIN <br />1�30 DAVS OF DA7E PENMIT IS ISSUED AND THEREAFTER IS TO <br />�E DI�IGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BV TNE GTY UPON ANV STOPPAGF OF WORK ON iHIS <br />PPOJECT OVEF 90 DAYS DURAiION. <br />