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��� <br />9Hti <br />��� <br />'� <br />�v�� <br />tA M <br />OH� <br />��8 <br />(�] V �] <br />t�y2 <br />HH <br />gy <br />H <br />CC� CGGG7 fn <br />C�1 � � <br />HO�n <br />I ._ � <br />i `�' <br />Date u��l� � '"' <br />� Applica.�an For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Ivtailin9 <br />Describe Proposed Wmk <br />` <br />�� � ��,��,���wo,wsP�� �. --y�_—. <br />nioo D�.ni . �(1'��i,�l_��%0—.—_. <br />z�n <br />Pao�¢wortefea $ <br />to�: � ve� <br />t�... niro: r�� n,,�n 5 <br />o.,i.,����.o��. S <br />Pwlec�Addresslilknown) �— j —1--- <br />Altach Inur (4) copies of plans lor proposed work � Draw !o scaie and �ote � Ceotedine of sUeel a61e: <br />• Property lines � Intlicaie Norih <br />• Outline and dimensio�s ol all eristir 9 antl � Show any proposed gratlin9 chan9es <br />proposed s�ructures on ihe IOI � Show mcasurements <br />• Exisiing and pro0osed utililics <br />NE <br />Phone <br />Phone <br />PERMIT CONDITIONS <br />1. All calls lor inspection shall be made 24 hrs. in advanco � phone 259•8810. <br />2. All work shall he pedormed in accordance with this permil and wrrent Cily ol Everett Desi�jn antl Construction <br />Standards and Specilications. <br />3. Call Location Underground Service 4B hrs. betore you dig. TOLL FREE NUMBER 1•800•424•5555. <br />Approvetl lor Conslruttion <br />Np �Ji'�l-lL �NO�t1GS IEKM�T I�CCViKLiJ <br />� - "Lo-90 <br />{ «...� �bl�Ka.�. <br />� <br />O <br />ACKNOWLEOGEMENf OF CONDI710NS <br />The undersi9neA owner/apphcani heicUy a9rec5 io hold and 5ave harnr <br />— less u�e C�ty of Evcrett ironi any ai�d all claims lor dama9es. r.osts. <br />r.xpenses. or causes of action that may arise becnuse of inslallation <br />end maintenance of Ihn unpravemenl or olher nghPol-waY ��ti<' here�o <br />applied br and Iwlher a9ree5 �o remove same upon naticc I�o�i� thc <br />Dale City and lo replace puUhc property dam.i9eA Ihereby <br />FlNAL INSPEGTION �:�t� ----�--. . _.. -- — �:'�" — <br />Approved a5 CanStrur.ted S�9nature ol Apphcanl <br />WORK l�UTHOflIZLD Hi 1H1$ PERMR 61UST BE STARTED WITHIN <br />i�vcrrll PUBLICWORKSD[PARiM[NT 180 DAYS OF DAT[ PERMii iS ISSUED AND iF1EN[APTEP IS TO <br />O 9200CetlarSlreet B[ OILIGENTLY PUF75UCD 10 (,J�dPLETION THIS P[R�d1T M11AY B[ <br />Everett. WA98201 ('ANCGLLED �Y iHE GITY UPON .� �JY STOPP�GE G� Wn�K ON iHIS <br />Phonc'.259�8�10 �i PROJ[CT OVER 90 DA'/S DUNf�I'l)N <br />