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�ucauon Fo� Date � / <br /> � PUBLIC WORKS PERMIT public Works Permil M <br /> PUBLIC WORKS DEPARTMENT <br /> 3200 Cedar Street <br /> Everett,WA 98201 (425)257-8810 Building Permit N � 1 q 3 l <br /> TYPE OR PRINT ONLY Tp POSTI NG ^"A ^ � �Ol public Worke Fee S D <br /> (m•�nip.zP�M� mi. <br /> �f�i�T�e,�r�ck z�43z oldqq S�r�woa� q8?AZ 3(a�-�v�- ?A-31 <br /> Applicant MalNng Addresa Ciry 21p Plwne <br /> Describe Proposed Work �n�.Q�( � <br /> — � <br /> � <br /> PROJECTADDRESS (if known) 5711 �� „�j ���'1 �� • O <br /> Attsch lour(4)copias plans lor proposod work• Draw to scale eiM note Iho lollowing II epplkeble: � <br /> •Proporty Lines •Outline end dimonslons ol all eMisting and proposod structuros on Iho lol •Existing and proposed utillties <br /> •Centerline ol street •IMMate North •Sfaw any propoaed prading changes •Show measuramonls <br /> DO NOT WRITE BELOW THIS LINE Z <br /> PERMIT CONDITIONS: O <br /> 1. All calls lor inspection shatl be made 24 hours in advance - phone (425) 257-8810 <br /> 2. All work ahall be perlormed in accordance with this permit and current City of Everett Design and � <br /> Constructlon Standards and Specifications. <br /> 3. Cell Locatlon Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800-124•5555. ♦/� <br /> �. �1 ti �+' ��Prove� pl�n da� �o�q �°I� . �O <br /> a a <br /> �f • t�( � ZGGeSS $ U'��i Gz Se IN�'t5 Mu� � (CGoIG� ANd Ti� <br /> Co ✓Uvic� �o -C�u �► r�ar �v acv�n <br /> � � � � � <br /> ���,�-S'- 3 �� -Goly' <br /> ACKNOWLEOOEMENT OF CONOITIONS <br /> G � The underalgned owner/epplicenl hereby apreea lo hold and eave harmleae <br /> tl�e Ciry ol Everetl Irom eny end all clalma for damepes,coste,expensea,or <br /> pro e or s ruc ion ' e causes of actlon IAet may edse because ol Inatelletlon arM malntenance ol the <br /> Improvement or other riphl�ol•wey use herelo and lurther egreea to <br /> �� � romove eame upon Irom Ihe Clty entl a r puWk properry dem• <br /> �� .�'l -- 5'���0/ agedlher y. <br /> FINAL INSPECTION ! Oale <br /> Approved es ConsVuctetl � � <br /> gne ur o �can a e <br /> WVRK AUiFqRIZED OY 7HIS F'EIiMR MUST BE STARfED WITNIN 1B0 DAYS OF DA1E M,1fT IS ISSUED NJD T}fREAFIER IS TO BE DNJOEMLV PURSUED 70 <br /> ODMPIFTION.7HIS PERMR M4Y BE CNJCF1lED BY 1F1E piY UPON IVJV STOPPACiE VJOFiC ON TH9 PRQECT OVER BO DAYS DURATION. <br />