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��� <br />m � <br />i•H�xy <br />a�Z� <br />~: H � <br />��H <br />x <br />��d <br />��g <br />(�] Y (7 <br />t+y� <br />HH <br />� <br />gdy <br />��. <br />�HV�i <br />HOtn <br />r .�� <br />Date_��d'Y� <br />APPCcahm For <br />PUBL.IC WORKS PERMIT <br />Print oi �ype Onty <br />���� <br />Applicant <br />Maihny <br />Tn p�cr��r <br />ess <br />_��� � �r z <br />ti+��i��,n an�fress � — c,�y <br />z�� <br />,��..,�-,�,.,.,,...m�,. R9-�s�o, - <br />,,.,,, o�.,,, . -g���a3a � �- � <br />-- --- - <br />r��si�wnnn�re __.._ _ "_ <br />���i.irPe 5'--. — <br />t..a. nm fnr Pa,�� 5__ <br />G : n�-- _ <br />e.�.,� ,.c�, s_ C <br />DescnbeProPosetlWork NP��p �yy��j�����/y�n� — ��,� � <br />.�.a.r <br />Pro�ec� AAdress I�1 known; <br />Altach Ipm �4� cppies ol plans lor proposed work � D�aw to scale anA nole the lollowinq as acolmahi,. <br />• Prooerry Lmes <br />f Out4ne and dimensions ol �II existmg anA <br />PiOpCS?tl 5�lUctUfCS On �he 101 <br />• Exiy��ng and proposed utilihes <br />• Centerline ol si« �et <br />• Intlu:ate North <br />• Show any proposEd qradinc7 thangr5 <br />• Show measurements <br />Fhonr. <br />PERMIT CONDITIONS <br />I. All calls for inspec6on shall be matle 24 hrs. in ativance � phone 259•8810. <br />2. All uod; shall be peAurmed in accordance wilh this permi� and current City ol Everett De �i9n and Construction <br />Slantlards and Snecificatlons. <br />3. Ca�l Location Underground Service 4fi hrs. bebre you dig. 701L FREE NUMBER 1•800•4243555. <br />( � <br />• ���/�/-.J�lr[��•_ �i'–J<�..�_��,L_. <br />Approved lor C nstruclion ���� <br />a � ,. . <br />� � � i;� �-- <br />FINAL INSP C � � p��� <br />Apnroved as Consirucletl <br />evcrrll PUBUCWONHSDEPARTMENT <br />� 3200 Cetlar 31ree1 <br />Evereil Pr'A n9207 <br />Phone�.259�P810 <br />ACFNOWL[DGC_M[Ni OF" CONDITIONS <br />W <br />� <br />�w <br />_/ <br />�� <br />� <br />�o <br />O <br />7hie undersignetl ownr.vnpplmnnl hmeUy. ,��ens lo hcld nntl si�ve h�n�,r <br />less �h�� Gly ol F.verett Irom 3ny �nd all claims frn Aamapes. c�;ls. <br />erpenses. or �auses of achon Ihat rnay anee becrmse ol inSLdla�ion <br />anA mam.tenancc ol ihe unprovemenl or othe� righPof�way use herclo <br />apPhed lor and Iuriher �qrces to iemovr sama u, on nolir.e hom ihe <br />GIy and to iepl;ice puhhc p�onerry darna9ed there�y. <br />� � � � <br />�__ � <br />�lure ol An ic. nt �ordc <br />W RK AUTHORIZ[D �Y THIS PERMIT MUSi �E SfI.RTEG NlI7HIN <br />1F30 DAYS OF DATE PERMIT IS ISSUED AND THERE;�FTER IS TO <br />BE DIUGENTLY PURSUED TO COMPLETICY. THIS PEHAIIT IdAY BE <br />CANCELLED CiY THE CITV UPON ANY STOPPAG[ OF WORK ON 7HIS <br />PRUJ[CT OVER 30 DAVS DURA IION <br />