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� �� <br /> � y <br /> 9HU~i � <br /> y �� Date i?,._,����90 � - ` PuM�c WO�Ae P�imi1• <br /> H ;u <br /> Application For eiaa osoi . 90 26106 <br /> �' " �° PUBLIC WORKS PERMIT <br /> vum¢WodsFen <br /> y H io�ei ven S <br /> � 'Y. � �essaoo�FecPse 5 <br /> ��-j b Uaivn<e0uc 5 <br /> � �"� Print or Type Only <br /> �^ �g <br /> ^,w n <br /> a y � Janice Stephenson 225 Bridqewav Everett 98201 252-7792 <br /> t' H y Owner Mading Atldress Cily 2iP Phone <br /> � <br /> nC ty y Owner <br /> Y � r Applicanl Mailing Address Ci�y Zip Phone <br /> E� t�a <br /> y� y Y i n W }'oYa �b��+�t3in rlo�k <br /> Describe Proposed Work _�]n�3LCt—� q—y-- <br /> W <br /> Proiect Adaress lif knov:n� 225 B=idgeway ` <br /> r <br /> Attach lour(4)copies ot plans br proposed work- Draw to sca!e and note the lollowing as appliw6le�. � <br /> • Properry Lines • Centedine ol street ♦^ <br /> • Outline and tlimensions ot all existin9 and • Indiwte Norih V� <br /> proposed slrucWres on the lot • Show eny proposed grading changes <br /> • Existing and p�oposed ulilities • Show medsurements /�/� <br /> W <br /> i" � -- DO NOT WRI7E BELOW THIS LINE <br /> �C]j PERI.AIT CONDITIONS O <br /> , I i.All calls lor inspection shall be made 24 hrs.in advance-phone 259•8810. � <br /> 1 � 2 All work shall be pedormed in accordance with ihis permit and current City ol Everetl Design and Construdion <br /> Sisndards and Specilications. <br /> , ��,' 3.CaIILocationUndergroundServico4Bhrs.beloreyoudig.TOLLFREENUM9ER1•800•424•5555. � <br /> � <br /> I <br /> i No-r�: �,�,�-�c��� S�in,��. v�e,��E r��i=c O <br /> ' � M,���--tz� �..�s � �- �o���-norJ � s r�� �.� � <br /> � <br /> oV�-`�'�. �.x tST �NE, S� �E S'���✓E7L, �/� <br /> H� <br /> I �� � <br /> ��o ��� ��o�.,�S � �T ��.���, a <br /> � , �-, ��.�� <br /> ' 1.z -s.F�-9c <br /> ' ACKNOVJLEDG[M11ENT OF CONDITION3 <br /> 7he undersigned owner/appliwnt heieUy agrees to hold antl save harm� <br /> ��� less the Ciry ol Everelt Irom any and all claims lor damages, costs, <br /> eapenses. or causes of aclion that may arise because ot installalion <br /> " and maintenance ol Ihe improvement or olher righ4of�way use herelo <br /> apphed lor and lurther agrces to remove same upon notice Iwm Ihe <br /> Appwved for Construction ���` City and to replace public property damaged IhereUy. <br /> FINAL INSPECTION Date � , ' <br /> Approved as Consiructed Sig t re of Applir,ant '� <br /> W AUTHORIZED BY THIS PERMIT h1UST BE STARTED WITIiIN <br /> eveiell PUBLICWORKSDEPAf7TMENT 1B0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> � 3200CedarSireel BE DILIGENTLY PURSUEO TO COMPLETION. THIS PERMIT MAY 8[ <br /> Evcretl,WA 9H2O1 CANCELLED DY THE CITY UPON ANY STCPPAGE OF WORK ON THIS <br /> Phone:259�8810 pROJECT OVER 9U DAYS DURATION, <br />