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L �?S�.-��� ' <br /> � kp' Date_ P,m���wo,.sP�,m,�. c�,�_y ^� <br /> � ��� v (S/�� e�ea oeoi . ���.?Sl.��-- <br /> �y AnPlicalicnFo� ,, T� POSTING <br /> , <br /> Pup4cWortefce l � <br /> � � PUBLIC WORKS `�ERMIT .o,a�F�. s-3����--- <br /> �� � C less/nn� FcrPeiJ 5 -- <br /> ^ �__. <br /> � fle�ancc Dun $� <br /> Print or Type Only � ": °' <br /> o� �p �'i �: �— o; <br /> �I M 'C � e' A di r <br /> '�y� C,..n�..r,..i f`�.e� T..n �G�X.�-/a�`,�..`�.� 1�a�/avb(� 7�'CbS <br /> � �,�, d � Owncr Mailin9 Atldr�la�� i,� �� ,;, �. Cify Zip Phonc <br /> OH � o " =. w <br /> Q� g � ,a,ri,�,r� lo �a r1'�����_�e� ao� .�,s9-;�c/ _ <br /> �Pli�nf Mailmg Address City Lp Phone <br /> t"y � i <br /> W H DeSCnbc Prop05ed�Nork �1�--�-'�'"-'1�"�"�'�'--�-�� '�, <br /> �� <br /> H <br /> �N � <br /> �O � I 7 � <br /> � -` Prolect Address lil knownl ---/�� � /J���-L � <br /> Atiach IOw�4)copies of Plans lor proposed work• Draw Io scale antl note t�owlne3 as apG�icabia�. � <br /> • PropenY Lines • Centerline ol streel ♦^ <br /> • Oull�ne antl dimensions o�all existing ana • lndicate Norih V� <br /> proposed structures on Ihe�ot • Show any proposed gratliny changes <br /> • Existing an0 pr000sed utilHies • Show measuremcnts M <br /> W <br /> - DO NOT WRITE BELOW THIS IINE O ��, <br /> j � PERMITCONDITIONS <br /> I 1.All calls lor inspection shall be made 24 hrs.in advance-phone 259•8870. � I <br /> ��� 2.All work shall 6e peAormed in accordance with this permit and current Ciry of Everett Design and Construclion <br /> Standards and Specifications. i <br /> 1 ' 3 Call Location Undergmund Service 48 hrs before you dig TOLL FREE NUMBER 1-800•4?4•5555. � <br /> ,_�� ,�. P� �,�r�,,,.P � ��,J ����� ���� -��� � <br /> � <br /> �,_ � <br /> � --' � . <br /> . O ', <br /> .�_ ::-, a � <br /> � <br /> � <br /> I ��� ACKNOWIEDGflMENTOFCONDITIONS ���� <br /> i '� ihe undersigned owner/applicant hercby agrees lo hcld and save harm� <br /> _ less ihe City ol Gverett Irom any and all claims for damages. cosls. <br /> ��, � � , I , `� expenses. or causes ol actica that may arise because ol installation <br /> �r� i'� a� and maintenance ol the imU�ovement or other righbol�way us� hereto <br /> applied lor and lurther ac�ree5 to rsmove same upon nolice from the <br /> - Appr ' pd r o Iructi � � ' Date City anA to replace public properry damaged lhereby. i <br /> � L <br /> / � . ,�! � > 'J � <br /> � <br /> ; ��� �( ,' , �_ .--�r;z� d.- �/- 9C- , I I <br /> FINAL INSPECTION � � j)�.� Date ' ' p� �, <br /> F�p�oved as Consiructed � � Si9n ire ol Appl ant <br /> bVORK AUTHORIZED BY THIS PERMIT MU T BE TARTED WITHIN <br /> ��i.��.�� PUBLIC WORKSDEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> � 3200CedarStreet BE DILIGENiLY PURSUED TO COMPLETION.TNIS PERMIT MAV B[ <br /> Everett,WA 9620t CANCL=LLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> ohone:259��010 PROJE(:T OVER 90 DAYS DURATION. <br /> i <br />