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Date <br /> 8 I� S� ^A POSTf lNG AP� al Q J� nr . / <br /> R���c Wmky Pn.mit s l J)�/i�_—. <br />' Appl�cation Fo� e�na oeo� • . <br /> PUBUC WO�RKS PERMIT �������N�.�s�Pe --- <br /> Tntai cpp $ <br />� .pssaor.l ��.oVa�a $ _ <br /> Print or Type Only er;,--,.c,... s�� .3Ci <br /> - � fL�r�a'roM►cc = /O,q75'- <br />, Grover Ahmann 713 Rucker Ave Everett, WA �9$.�01` ZSZ- 74'7a <br /> I <br /> I Owne� Mai�inq nr,�re,ss i G�Iy . 7_r. Pt,nr, <br /> -i . <br /> i , r <br /> i� APPlicant wQIC�'1'(7U�C{�� Frontaee Itt`ti`provemen'Yg P"<,m--____-__ __.._. <br /> I <br /> Describe Propos�d Work ______ ____________ <br /> ��9-- Braadwny-- -- ---- W <br /> Projec�Addressldknownl __ _______ _ __ L <br /> Attach lour!4) copies of plans for proposed wo:k - Drav:to ,rab, ar�.n nc:h�the !c�lowmg as anuhwbie. � <br /> � <br /> .� • Prope�ry LmeS • CeMeihne n} Streut � <br /> • Oulhne and dimensions ol all existing anrl • IecLr.abi North <br /> proposed structures on Ihe tot • Show any r.r�nosed y�ahmq r,hanyus <br /> • Ezisting and proposed ulili�ie5 • Show mrasurements � <br /> GO NOT WRITE B[LOW THIS LINE <br /> PERMIT CONDITIONS O <br /> 1.All calls for inspection shall be made:!4 hrs.in advance•phone 259•881 O. � <br /> 2.Ail woik shall be pe�formed in accordance with this permit and current City of Everett Design and Construction <br /> Standards and Specifications. <br /> 3.Call Location Underground Service 48 hrs.belore you dig.TOLL FREE NUMBEH 1•800-424•5555. � <br /> '�, f15 �+c�' �����d P 12+n s darf,cd 8/ii�is O <br /> S. K(,Gp G��j Sf/Y-G�S GIL�tH Af GI�I �'��►9G5. � <br /> / <br /> �P• EM,tian Gnn '�ro ( .�i1 dreef�d 6ts � ,'hs�eL�v�''.. � <br /> � O <br /> O <br /> a <br /> AGI�NOW'LECGCP.iENT iJF CONDITIOIJS <br /> 1 hr�.i�dr,i��,�ned ouvnei/aUo�icant horeUy agrees lo hold aod sace hnim- <br /> -/y/�— �� less Ihc Cdp of [verett irom any and all claims for Aamages. r,osis <br /> uC����/�. �/// %� expenses. o� causes of action ihat may ans= becanse of inslallat�en <br /> � H���� — and maintenance of ihe improvement oi o�her nghbol-way use- he�etn <br /> �V— <br /> ApProved tor Cons�s6ction 3t � � �PP���'d �or and furiher agrees to remove samn upon notice Irom Ihe <br /> � � Gty inA to replace public pronerry damaged thereby. <br /> _Q�==�„� /— ��y C � (/%-- / — - <br /> FINAL INSPECTION Date I y�_�J�*-� �i. . / ��`�c:"^ '� �� ��� �'-� <br /> Approved as Constructed I Signatwe ol Apphcant � Dab: <br /> PUBLIC WORKSDEPARTMENT WnRK AUTHORIZED BY 1HIS PERMIT MUST BE STARTED WITIIIN <br /> 3200Cedar5lreet 190 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett,WA98201 BE DILIGENTLY PURSUED TO GOMPLETION. THIS PERMIT IdAV BE <br /> Phone:259-8810 GANCELLED BV TH[CITY UPON ANY STOPPAGE OF WOfiK ON THIS <br /> I PRO,IEGT OVER 90 DAYS DURATION. <br />