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Date 5-25-93 PueucworwaPermrt• g�/ <br /> Appiication For <br /> eiaa�oeo�.• <br /> PUBLIC WORKS PERMIT PVbTOWieeFm 5 -- <br /> ~ less nooi�ee�sa S <br /> Oa <br /> ,p�� Print or Type Only e�i,�«o�� s -�5— <br /> y H tHi� CtJZ -.f2L`/O�/8.3/ <br /> r -9 <br /> H Z 3 Iiark A Qui�ley 2933 Rockefeller Everett, WA 98201 339-1323 <br /> � y� Owner hlailing Addre55 Cdy Zip Phone <br /> y �� D1ark A. Quigley 2933 Rockefeller Everettt, WA 98201 339-1323 <br /> � O n APPliwnt hlailing Atltlress G�y Zip Phone <br /> HC <br /> � �g oescnbe Proposed�tark Asphault parking area install water meter per revised plans of 5-25-93. <br /> c�� n <br /> r H� � <br /> ti <br /> H 1223 Broadwav Everett WA 98201 � <br /> �7 d y Prolect Address(if known) <br /> � �� F�tad�fow p7�cOpi05 0l plans lor proposed work� Oraw lo Scale antl no�e Ihe lollOwing as appiiCaDlC: � <br /> z y[� • Property Lines • Centeri�ne ot street �/� <br /> �7 O p� • putline and dimensions oi all e��stmg:i�,�f • Indicate North N j <br /> proposetl slructures 0�ihe�ot • Shmv any pro,ose:f yraclm9 chane�es <br /> ! Exi5ling and proposed ulihLes • Show mCasuremCnlS M <br /> W <br /> DO NOT 1YF71T[ �ELOW iH15 LWE O <br /> PERMIT CONDITIONS <br /> 7.All calis lor inspection shall t�e matla 24 hrs.in ativance-phone 259•8810. � <br /> w.� 2.Ail work shall be pedormea in accordance with this permit antl current Gly ol Everelt Dr,sign and Construction <br /> � � Stantlards and Specilications. <br /> � 3.Call Locatlon Undergroun�f Sonice 48 hrs.belore you dig.TOLL FREE NUMBER 1-800•424•5555. 7 <br /> // / � i� <br /> t'��' T, e�� Ccib:�G �o � �O7+c-. /2` '_ �`-f.:� _ . . ;.�.�� O <br /> � yy- ���� _ <br /> •. �� O� J -.;JC -i-�', /CL�J riClr:C�'..I� <br /> � � <br /> � ._ �' �w <br /> � � _/ <br /> �a Q <br /> � a <br /> '��� � <br /> ACKNGWLEDG[tdENT OF CONDITIONS <br /> _ ' Thu undeisic�ned ownet/aUPlicanl herCby acJr0e5I0 hold and sa�'e hainr <br /> 1e55 Ihe Cdy ol Everett Iwm any and all claims lor damayes, cosls. <br /> // eapensec. or causes ol aclion ihat may anse hecause ol installation <br /> �/���� s��93 and maintenance ol Ihe improvement or other righPobway use hewlo <br /> . /1z applietl lor and lurther a9rees to remove same upon notice Irom Ihe <br /> Approved lo�Constructi ��� City and to repla[e publiC property damaged Ihereby. <br /> ��----� 6-�' i3 �. � � " ` - �-� <br /> F�rdA� iNSP[ctloN Datc �r•��"./�" ('� `�L�'1'`"`t G"� /-, <br /> Apprcved as Conslrueled Si9naWre ol Applicant Date <br /> PUBLICWORKSDEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 100 D�VS OF DATE PERMITIS ISSUED AND THEREAFTER IS i0 <br /> � 3200CedarSlreel BE DILIGENTIY Pl1R5UED TO COMFLETION.THIS PERId1T h1AY BE <br /> [vcrett,WA98201 CANCLLL[D BY TH[CITV UPON ANV STOPPAGE OF WOHK OIJ THIS <br /> Phone:250�8870 � PROJ[CT OVLR 90 D�WS DURATION- <br /> , <br />