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V � Y-2 %s <br /> �p•��cation For �� <br /> �i��� PUBLIC WORKS PERMIT Date_ 3/26/96 <br /> PUBLIC}yuRKS DEPARTMENT Public Works Permit# _���� <br /> �(����[Ih � ( " �i_ �' , 3�OCedarStmet <br /> ���V v '� �vemtt,�198207 259-8810 <br /> 8 Builtling Permit#�17 <br /> iYPE OR PRINT ONI_Y � g g g '�, g g g g � pp <br /> + tv m vi � uiI � • • Pubtic Works Fee$ �S-�_ <br /> O M N M ~ M M N � P <br /> _ fiVERETT SCHUOL UISTRICT ^ 4�0 COLBY E •REFS' 992��"3 �� <br /> Owner Mailin�Addr s� .. ti p�� <br /> � � y Z�P Phone <br /> U <br /> _ STADIUPi COFFEE (LARRY OVj$,�2H0 � �1�8 � � •�� �+g?GS) 337-3600 <br /> ����+cant Mailing Addr s ��� — <br /> Y Z�P Phone <br /> Uescribe Proposed Work PEP.MANENT �SPRESSO aTArD <br /> W <br /> F- <br /> - <br /> PROJECTADDRESS(if known) 3830 RNtJAD41AY � <br /> Atlach four(4)copies o1 plans for proposed work-Draw to scale and note the following If appliwble: � <br /> •Property Lines •Outlinc and dimensions of all ezisting and pmposed stmctures on the lot •Existin�and proposed ulil'ties O - <br /> •Centerline of street •Indicate North •Show any proposed gredirg changes •Show measurements <br /> �-- DO NOT WRITE BEIOW THIS LINE � <br /> FERMIT CONDITIONS: � <br /> 1. All calls for inspection shall be made 2-0 hours in advance- phone 259-8810. <br /> 2. All work shall be pertormed in accordance with this permit and current City of Everett Design and O <br /> Construction Standards and Specifications. <br /> 3. Call L.ocation Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � <br /> /i !//^/(/fCdQ,c� �f7Tr4.r7[L D/� O/^OQdlt/c2�7 �// <br /> � <br /> /J�vs1'` �c� /'�pL4CCc,l �Jer Ci�fi .I'�.���.�o� #307 � <br /> � . a <br /> n . ��_ � <br /> ' � � / / 'C��L-.•rlcii�.s-i..� <br /> "• J/O'eSe�CJE/'"' fyJGS/' 02 /f7,S/4 ��ecY �/^ s7�'ano� ��� � <br /> -��oz �yd �a¢ , i <br /> �� <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> � �J �f The undersigned owner/applicaN hereby agrees to hold and save harmless <br /> ,(✓ p�f—^ / S �6 the Ci�y of Everett irom any and all claims for damages,cosis,expenses.or <br /> Approved� r Confhuction _ p �e causts ol action ihat may arise because of installation and maintenanr.e o1 <br /> � �(' the improvement or other rigM-ol-way use hereto applied for and further ag�ees <br /> /�/ to remove same upon notice from the City and to reptace public propeAy <br /> �✓%��' - �.io -�l damagedthereby. <br /> FINAL�NSPECTION pa�o <br /> Approved as ConsWcted /' A `� <br /> ��''L �7 � CG'J J <br /> Signature of Applicanl Date <br /> WORK AUTHORI2ED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PEFMI7IS ISSUED AND THEREAFTER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLETION.TFiIS PERMIT MAY BE CANCELLED BY THE CIlY UPON ANY STOPPAGE OF WORK ON THiS PROJECT OVER 90 DAYS DURATION. <br />