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� �ltatiw�For <br /> PUBL(C WORKS PERMIT °��e �'12�I� 9 <br /> PUBIJC WOFKS DEPAFTMENT pubi.c Nbrks Permit M ��d37 <br /> 3200 Cet1ar Sin_�et <br /> Everett,WA 98201 259-8810 guilding Permit 1� _ <br /> TYPE OR PRINT ONLY Public Works Fee$ �� <br /> -�ID�'�cAn1 ��sTiPiBu niJ� 3kd 9 BRo�r.�.v9 v F✓�� 9rro� y�aS� a►a le <br /> Cvrer Mailing Address City Zip Phone y,,.�� n <br /> M��V7 DETR�E�T <br /> ��i�� � �01�� <br /> Appliwnt Mailing Address Ciry Zip Phone <br /> Describe Proposed Work �EP�-AGE 2q � OI- �� 3 F ' Bawt� � <br /> �S'ocJT}} " a' ST EASL.$1D� 6F QRoR�wR41 � <br /> � <br /> _ V♦ <br /> PROJECTADDRESS(ifknown) �aAYYIE RS A4oJ� � <br /> Attach four(A)copies o1 plans for proposed work-Ora�v to scale and noln the following If applicable: O <br /> 'Property tJnes `Oulline and dimensions of all existing and pmposed structures on iha lot •Existing and proposed uNliUes <br /> •Centerline of street 'Indicate NoAh •Show any p�oposed grading changes •Show measurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS: � <br /> 1.All calls for inspection shall be made 24 hours in advance- phone 259-B810. O <br /> 2.All work shall be performed in accordance with this permit and current City of Everett Design and <br /> Construction Standards and Specifications. <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � <br /> 4� �'u I I 33�1 -�7�-03 -�'r �e -c,ons-lr..�f;Q� r,.1e�rl�r� V� <br /> w;'� � n s�.ec�- r���r��n y cu r,h d�f�; I . � <br /> �,,;� a <br /> ��^k k �.�+ <br /> � <br /> ���� � • rt <br /> � <br /> � � <br /> �d ►�' � <br /> ����� ,r <br /> 1 <br /> � The undersignetl ownedapplicmt hereby ap�ees to nWd and save harmless <br /> zz4 � the City o}Everatt hom any and all clMma for dam�pee,costa,ozpenses,or <br /> Approvnd for Construchon D te — causea of ection that mey erise becauae o}InMelletbn and maintenance ot <br /> . the Improvement or other nght-of-N�ay use hereto applied for and'urther agrees <br /> to remove same upon notice from the Clty and to repince public property <br /> damaged thereby. <br /> FINAL INSPECTION Dete <br /> Approved as Construded ""� (`� 1 <br /> lr�u1� l�J �.Iz3 �99 <br /> Signature of App icant Date <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED VJITIiIN 10�DAYS OF DATE PEFMIT IS ISSUED AND THEREAFTER IS TO BE DILJGENILY PUFSUED TO <br /> COMPLETION.THIS PERMIT MAV BE CANCELLED DY TNE CIN UPON ANY STOPPAGE Of WORK ON THIS PROJECT OVER 80 DAYS DURATION. <br />