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` �B�Q��'�J�9 r PUE1K WorF�Pe� • �_ ��� <br /> / / <br /> ADDIIcetion For eina oeo� . _ <br /> • ' PUBLIC WORKS PERMIT °°°;a;Fsa`°• . <br /> lese�oo� �ee Vun 6 <br /> PrintorTypeOnly a.�.�<.o�� s �O`�— <br /> .Io/fn R'LS/ll/'is �1��e� ��'.?S �l lf'� C��+<..G� .��` � —/3S/ <br /> Ownar M ilingAddresa� City Zip Phone <br /> / <br /> A" �Le�J'"i'��7�orS /7/07 ��w. SS' /-������ �s�3 -9J�/ <br /> Ap� Meiting Atld�ess City Zip Phone <br /> Describe Propoeed Wmk � � /�/��sl�. U� i .�.�4 / <br /> �Q.�:.�Caa.c� J .L`�-`„ �/w i �..�' _ <br /> Prolect Addreee pf known) �d o�_T .�. � <br /> � <br /> Attech lour(4)coplae ol plane lor proposed work� Drew to scale and note the lollnwing ae applicable� � <br /> • Property Llnee • Cenlerlina ol elrexl � <br /> � Oulline and tlimenelone ol ell exleting and • Indiceta North <br /> propoaed structures on the lot • Show eny proposed gredinp changes <br /> � Exleting end proposad ulllfllee • Show meesuremenls � <br /> DO NOT WRITE OELOW TNIS LINE O <br /> PEHMIT CONDITIONS <br /> t. All calle lor inepectlon ehell be mede 24 hrs. In advence- phone 259•881 5. � <br /> 2. All work ehell be pedormed In accordance with�hia permit end currenl City of Everett Deslgn and ConsVuctlon <br /> Slentlarda and Spatilicallonn <br /> 3. Cell Locatlon Underpround Service 48 hrs. belore you dig.TOLL FREE NUMBER 1•800•424•$$55. � <br /> O <br /> � <br /> � <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/epplicent heraby apreae lo hold and eeve herm- <br /> lesa the Cily of Everett Irom eny and ell claime for demepe& coet0. <br /> , erpensea, or ceueea ol acllon thel mey erfae becauee of Inetellatlon <br /> � �� � /� 8� and melnlenance oi the improvement or othar rlght�ol�wey use hareto <br /> Approvetl lor Conslru� Date eppl�ed lor end lurthor agrees to remova same upon notice Irom Ihe <br /> -- City and to replace public praperty dameged thereby. <br /> i -//�.� � / <br /> FINAL INSPE 10 Date � �'Z/� <br /> Approved ee Con�tructed S ature ol Appllcent ,�`�T— eta� <br /> everett PUBLIC WORKS�EPARTMENT WORK AUTHORI2E� BV 7HI5 PERMIT MUST BE STARTEO WITHIN <br /> � 3200 Cedar Sireel 780 DAVS OF DATE PERMIT IS ISSUED AND THEREAfTEF IS TU <br /> Everaft,WA 98201 BE DIIIGENTLV PURSUED TO COMPIETION. THIS PEHMIT MAV BE <br /> Phone: 259-BB15 CANCELLED BV THE CITV UPON ANV STOPPAGE OF WORH ON THI5 <br /> PROJECT OVER 90 DAVS �URATION. <br />