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� y <br />C�� <br />�Hy <br />H�� <br />FC t] <br />H :U <br />���yz <br />o�o <br />��g <br />�Y (] <br />t"y� <br />hi y <br />8 �' <br />c�b��i+ <br />� �. <br />H U�i <br />HO�n <br />� <br />1 ' <br />.Jale.tlL-_I-7 � +` <br />PU�IC <br />a <br />� <br />Print or Type OnlyQ <br />r <br />w <br />� <br />;J - Cc - a-G�'� J <br />nPvlicatron Far <br />WORKS PERl1AIT <br />1l10011') b �p O <br />o.poo-oo oo:,o <br />dM.r � a aP 6l <br />a .w «..-. <br />C]�U �=�3.1�-i <br />�����gl�� <br />A4nihnq4dtlir�ss'___�� Cdy <br />�•.:�, - �•::.,�. ��,.,,. �� J.�7_ �q�` �`Jf'�7 q— _ . <br />oinB Deo� • __ 7-4l�_L�;,l1lQ_(..� - .. <br />�;,�,�,�w�,.,«,- S ----- <br />.�,.,� �.e <br />�n,.a�.,��.,..����,s _ <br />5 � -- <br />B.�km� �. D��.. <br />t�Vt_ 9-�'� .3��-7���� <br />lip Phone <br />-- Lip-- — Phone <br />Descri6e Proposed Work __!%/«���-�, — <br />Pro�ect Address �il knownl <br />� <br />Atlaeh lour lal copies of plans lor proposetl work � Draw to scalo and note ihe lullowmy a; anPlicable <br />• Propeny Lines <br />• OWline and dimensions ol all existm9 anA <br />proposetl structures on Ihe lo� <br />• Existing and proposad ulihlies <br />�1 <br />� ��C(, <br />• Cr.nlerline ol sireel <br />{ Indicale Norih <br />• Show any p�oposed 9ra�m9 ch, nqes <br />• Shnw mcasuren�f�nis <br />PERMIT CONDITIONS <br />1. All calls lor inspection shall be rnade 24 hrs. in advance � Uhone 259•8810. <br />2. All work shall be perlormetl m accordance with this permit and wrtent Cily of Ev� rett Desiyn and Conslruction <br />Jiandard�� and Specilications. <br />3. Call Location Under�round Sen�ice 48 hrs. helore you dig. TOLL FREE NUMBER 1•800•424•5555. <br />�}, \V�TF3Z- 7GY'-�i� LE "FOZ EX�ST�NC-� HWSE. ON LOY '�L 1(y(oz,(a� <br />\ <br />l o� c� vaz'�O � wlErr�tEi� ��rc u i c e c'b� -n+ � s a� ���E x <br />hl�w SQt-vl�f <br />TO 5E �� S�u..c� rt� �oT �'-Z , <br />� I�J—Z4'`i� <br />g-.--l�—��-- --- <br />�pprove0 lor ConStru ion Date <br />j /. <br />��•'� �-�-" T-�S_3/ <br />FINAL MSPECTION Date <br />Fppwved as Construr.ted <br />evru�ll PUBLICWORKSDEPARTMENT <br />� 3200 Cedar Sireel <br />[vere�l. WA 98201 <br />Phane:259�8�10 <br />AI;h�JOril.f:DGf_W[Nf Of' CONDILONS <br />W <br />� <br />�w <br />s / <br />11 <br />� <br />Z <br />� <br />The unNlisiy��aA on�nr�r„qlPLuu��l bci�•bY ��]�ees lo hold and savb hanm <br />less Ihu Cdy ot E�melt hom any ,md .JI clainu for dama9es. cosls, <br />expenses. or causes of action Ihat may anse Lecause ol inslallation <br />�nd mainlenance of Ihe impiovoment or othe� ri9hPobway use hemlo <br />nppLr.d �or antl lurlhu� aqlnes lo n±nIDve Sante upon notice IrOm Ihe <br />_ /� �%L_ <br />oiynamm o� Nnpi��ant Date <br />VJORK AUTHORIZED BV TFIIS PEiRhilT MUST �E STARTED WITHIN <br />180 DAYS OF DATE PfRMIT IS ISSUEO AND THEREAFTEH IS TO <br />�E DILIGENTLY PUFSUED TO COMPLETION. THIS PERMIT h1AV P.E <br />C�NCLLLED 6Y TIIE CITY 11PON ANY SiOPPAG[ OF WORK ON THIS <br />PHUJI_C1 OVGR HU U�'.YS DURAIION <br />