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� - �-z2�-�i <br />Date�� <br />Appllcatlon For <br />PUB�IC WORKS PERIIAIT <br />Print or Type Onry <br />� <br />. <br />T(1 POSTING �, ��'`1-a— <br />Zip <br />...� :. <br />9 <br />�II �L4.7 � <br />r„m��wo��.r.n,mn/�..27�/9 - <br />nino nno� . J1 �— . <br />r�u,� wm�. r.• <br />iotel Fne a - <br />LnsNnn� Fea P��E S _ <br />PHen-eDue S � <br />- /533 <br />q:� . <br />. <br />ApPlicent MailinpAidress City Zip Phone —�� 1 <br />1 <br />D�scriba PiopnsaA Work /C�F'LI � J Cg "�3O'-� S7- � <br />Proi���� Address lil known� <br />Allach lour 14) �opios ol O�ans lor propo9ed wo�k � O�aw lo scale nnd noto the foll�wing as apphcahlc <br />• P�operry Lines • CeMerGne ot slwel <br />• Outline xnA dimUnsions ol oll o.isling nnd • InAicate Nnrth <br />proposed slmcWres on the lol • Show any pmposetl g�uAing changos <br />�� Exislinn end uroposed Wllities •;how measurements <br />�t ' <br />���; PERMIT CONDITIONS <br />- 1. All cells lor Inepeclion shell be made 24 h�c. in advance - phone 2541•8810. <br />� I 2. All work shell be peAormed in eccordance wilh Ihis pnrmil anA currer�t City of E+orett Design end Cunslmctlon <br />Stendnrds and Speci�icationn. <br />( 1 3. Cell! ocation Undcrground Sorvice 48 hrs. belore vou dig. TOLI FREE' NUMBER 1•800•424•5555. <br />� � <br />� <br />' 1� <br />�1. l���t;it] ra,-'. car�p,tr��,-.� ir��n r�r t gn�_.,- ���:=inn�! .I� �.-.�.�.r� „– r�„�_ _.i 1_�. <br />•-t�nrl�rC1 tl"�rf�+ and t•r ���.�c�n �r�nfr�il ,�. �i��, �J �. !���rl�� Io�,r�.-. <br />.� -� � ... ., _ _ .. _ . <br />Insnectar. <br />.. �irrep ��:i.ty sfreet_ �lean aP al l ti.mc��. <br />��. Ci_irb qi.iNer arid �_i.dewalV�. in the u1.��* ���� rn���, .�n��� n��a:��n.�a��it. <br />an1' damaqe lhezrrrtn :hal l be repl,-�ci�rl .it , P�e �Ji�--�:,:.rr,1 ,nr, ,�, � In� <br />F'ubiir Wnri�s 1nsFacl:or�. <br />/. An�� chan�le in the driveweri ci.�t must be' aPUruverl by t:he P��.:il i�. <br />IJorF�.s lrapector. <br />0. Tiqhtlinr �11 r'oui, ��ar�d an�.� (JI�LVBWd% drains to storm dr�.���� <br />stubs at hacl��. side of sidew��l l.. <br />9. Adi�-�sf. w��trr- bo:;e< tn ar<�de af. <br />LU. Driveways sh:+ll be paved troa� <br />,.(� fr�r.•l i.il lu loi .. i I i=:' i��r'rrim�nJr.,�l �. <br />��.—Nl�ke�. __ � -`� <br />�pproveAlorConS�roction . Dalr <br />= � �� / <br />� -� — –___f ' ` — <br />FINALINSPFC710N �°�� <br />Approved as Conslrutted <br />r7 pUBLIC WORKS DEPAFTM[NT <br />3200 Coda� Slroel <br />� � Everetl. WA 99201 <br />Phore.25&Bfl10 <br />W <br />H <br />� <br />N <br />� <br />O <br />� <br />� <br />� <br />a <br />�.nrl ai conslr,�it�.:.n. �� <br />i� ��_I �da� of sidc.•�,'.I ., roinirtn�in r,. <br />�. ��n7 i i C� clr� : ���ei,��; �i . i�,i:=qJ. <br />ACKNUWLEOGEMENT OF CONDITIONS <br />lho unCersiqned owne�/applicanl hereby aq�ers lo hold �nd save harm� <br />less Ihe Cdy ot Everelt liom ony and 'ell clmrns lor don�a�es, cos�s, <br />e�penses, or cnuses ol aclion ihnt may anse I�ecause ot installaLoo <br />and mamlenance ol Ihe improvemen� or o�he� r�ghl-ol�wnY use h�,reto <br />applind lor end lur�her a9rces to remove same �ipon notice I�cm the <br />Gty anA lo replacc pubhc properly tlamapr.d 1Fcroby. <br />�,<��,�,,,�J��,�`�„� — y� — o.,�� <br />WORK AUiHOF�Z[D 81' TIi15 PERMIT MUST BE STAtiTED W'THIN <br />I80 f7AVS OF DAT[ PERMIT IS ISSUED AND THEREAFTER 13 TO <br />�E DIUGENTIY PURSUED TO COMPLETION TH!S PEPMIT MA I BE <br />CANCELLE� �V THE CITV UPON ANV STOPPAGF OF WGRN ON 1HIS <br />PROJECT OVCF 90 DAYS D'JRATION <br />