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App�icatbn for <br /> Date J�n� �'¢ �9�9 � <br /> PUBLIC WORKS PERMIT oublic Works Permit M 9�- _ <br /> � PUBLIC WORKS DEPARTMENT <br /> 3200 Cedar Street Buildin Pertnit k <br /> Evereri,WA 98201 (425)257•8810 9 —' <br /> Public Works Fee$ �SQn <br /> TYi'E OR PRINT ONLY 8 <br /> rv�r�-i i" !✓D�I� SCtioo�S 47.30 Cn�6� �vGI'�iT �BaO� 388— '¢'73� <br /> �Mailing Address City Zip Phone <br /> °wner 2s9 - Is�a <br /> �. .� .. � � •�_�1� ?�722 Colb.� �'Go7_ �vera-f� 9a�o1 <br /> ppplicant <br /> DAailing Ad ress Ciry Zip Phone <br /> Describe Proposed Work �e�✓ S I�GwR�� �� �VGfG� MzmOr/�� W <br /> OV aG ti /� ,C — GG LLCGC O RG � <br /> �/1 O �4 7 i1 G 07G a!l ' a S .�r1 � <br /> PROJECTADDRESS (iiknown) 390o BrOrc��✓�y � <br /> O <br /> qtlsch four(4)copies pians lor proposed work-Drew to sale and note the lollowing if applicable: ^ <br /> •Property Lines •Outline aM dimensions of all existing and proposed strucluree on Me bt •Exisling and proposed ulilities � <br /> •Centerline of street •Indicate Norfh •Show any proposed g2ding changes •Show meesurements � <br /> nn .�.._...— <br /> PERMIT CONDITIONS: `� '� O <br /> 1. All calls for inspection sh. I,/LJ�� ' n ■ <br /> 2. All work shall be pertorm� ^ � Jfl H / r <br /> Construction Standards ai , /I / � '-1� /� �C �'✓ /^ <br /> 3. Call Lxation Undergroun !l / � ��4 � / V♦ <br /> � V ;� � <br /> 7„ l(/Dr� f� 8e � a <br /> , ,� l <br /> 5 �eP crfy sf�� ; � ��____ <br /> / T/ r // <br /> fo• //1/S �rmr� ti v , t <br /> 1'Yl o n rr8l^/�i� at' , <br /> ' , w�onG6ili��t �b /t�SurP <br /> CLQ�nL�neSJ'• . . •.-• � <br /> , <br /> fha� �he ph��l�s�rr4 h la/al,Fk�/ is eonst��c.�d c�� ,�rec�C� . <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/a�plicail hereby agrees to hold and sava Y�armless <br /> 7 � p� the Ciry of Everett irom any and rill ciaims tor demages,costs,expenses,or <br /> L— causes of action Ihat may ari=_e bxcause ol Installation and maintenance of the <br /> prove n ru� � improvement or other righ4of•way use hereto applied tor and further ngrees to <br /> / remove same upon notice from the Ciry and to replace public pmpeAy dam• <br /> aged Ihereby. <br /> FINAL INSPECTION Date <br /> Approved as Conslnicted igna re o pp ican a e <br />' WORK AUTHOR4'ED BY THIS PERMR MUST BE STARTED WITHIN 1B0 DAYS OF D.ATE PERMR IS ISSUE�AND�HERFAFTER IS TO BE DIIJGENTLY PURSUFD lD <br /> Cq�l%,Efl01r.'�}iIS PERMR MAY BE ClJJCELLED BY THE CITY UPIX`!M1Y'STUPPACaE OF WOFiK OP1 THIS PRQIECT OVER 90 DAYS W RAT10N. <br /> � <br />