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o.ie � <br />�pplk�tlon For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Owner <br />AppI1C�n1 <br />Pl�n Ch�ek No� B 79{]1 <br />Appllc�t.D�t�� 07/07/9J <br />Job �dA� C, �e[RTS N011DM11Y <br />t�n�nt� <br />P[opoud U��� R[T�IL OROCiRY <br />D��a. of Mark� <br />TLNANI IMPIIOV�IQNT <br />9lPA <br />Oa�crlbe Praoo�ed V�ar� °��I��c e�r _�oe esr <br />�PPI'.OtRD IOR PEUMIT� D111'[_/_/_ 6Y_ <br />ProNct Aeereu PI Mnownl <br />NNCWM�hnM• <br />!MO OM • <br />.�...,...,« � <br />,a.�... <br />uu �oq M wa t <br />l�4K�Du� � <br />Zip Pnone <br />=m Pnone <br />AU�C� louf �4� Cople� 010���� b� propo�ad wod � Dr�w lo a�le en0 aote iba lollawinq u ep0�����le: <br />• PropetlY Line� • Cenlerune ol �Irset <br />• Oulllne �ntl Elmen�ion� ol �11 e�inun0 �nU • InCicUe Non� <br />pmpo�eC �Imclure� on I�e lal • snow .�y o�000see a�.ema �n.�ae. <br />• E�I�tlnq �n0 Oropo�eE uldilla� • 8hnw meem-emenb <br />PEFMIT CONDITIOIIS <br />t. Au un� lor iropactwn ah�n bs m�0s 2� nn in �dv�ncs • chon� 269�BB10. <br />4. All work �MII be DeNomieE In �ccoN�nce wllh I�It permll �nd cumnl City ol Erarott Ualpn �nd Con�iNcllan <br />81uMud� �nE 8psclllulloni <br />9 Ce0 LocUlon Untlerqround Servlce �B hn Eelorc you Aip. TOLI FREE NUMlE111 •800�+24•6663. <br />PUBLIC WORNg pERy1T <br />NOT REOUIRED <br />flV_ +�i <br />��TE J vY� <br />IApproved lo� Comlmclian D�te <br />FINAL IN9PECTION D�le <br />Approve0 u ConnrucleE <br />PUBLIC WORNS DEMRTMENT <br />0100 CM�r Blrnl <br />Ev+nit WA BB201 <br />rno�.�.aea�ae�o <br />ACNNOWIEDOEMENT OF CONDITIONS <br />W <br />H <br />� <br />N <br />The underalpnaC Owne�/�OG�IOnI hl�tby eqree! �o �oIE �nC Wve hlrm� <br />leee I�e C�ly ol Everell Irom u�y mE �11 Cbim� �at E�m�pe4 W�IS <br />e�psn�ef, or cwee� al ¢I�an In�l moy ube E�cewe ol In�Ull�llon <br />�nd mninlan�nce ol l�e Improvemml or ot�er tlp�Po4w�y uw �ento <br />eoolieC lor �ntl lur�nar �O�ees lo nmova um� upon nolin Iwm t�a <br />Clty �nE lo re0���� PUEIIc property A�m�p�C Ih�qby. <br />Siamlure ol AOP������ Dete <br />WORN �UTNORIZED BY 1HI5 PERMIi MUST BE STARTED WIiHIN <br />180 D�YS OF D�TE PEPMIT IS ISSUED AND TNEREAiTER IS TO <br />BE DILIOENTLY PURSUED .O COMPLE110N. iHIS PERMIT MAY BE <br />CANGELLED BY TME CITY UPON ANY STOPPAOE OF WORN ON THIS <br />PROJECf OVER VO 04Y5 DURr1110N <br />