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Date_�4'1"�� �,,� �•,_..� ��'�� <br /> l�DPlifahcn For ni,tq �.�i . '..(,�� �G,7(�,��/� .. <br /> PUBLIC WORKS PERMIT �"�;�w�;;;<<� s <br /> �..,..�,�,� �..o.��, s � <br /> Print or Type Only F�.•�.,�.,.n„� 5—'-� __ <br /> T,►�n T-r�r r_���rr� ���� �'�'�.c.j �� ��c�'�c-�f Q��� <br /> Owne� Maihny Atldre55 6Ay Z�n Phone <br /> 4�1'- '��� <br /> Appheant Mailmy AAArrsS Gty Lp _'— P�one ----.. . <br /> Describe PrOposed Work ( ������_ ___ <br /> Prolacl Adaressld knownl — ��l�F�'. ! L.C\1 �l �-�_ _ � <br /> Allach�our(4)cOpies ol plan510r proposed work� D�aw lo scnle antl nole Ihe lollowmn as apph��al�ir � <br /> • Pruperty Linas • Centerl ne ol street � <br /> • OutLne and dimensions of all e�istmg antl • Indicn�e Norih <br /> propOsed S�ructwe� on�he lol • Show nny pwPosed yradmp chanqes <br /> • E�isimB and pronosed utihUes • Shon mensu�ements � <br /> DO NOT WRITE BELOW THIS IINE <br /> PERMIT CONDITIONS O <br /> 1.All cells lor Inspaclion 6hell be metle 24 hrs.in edvanca�phone 2S9•88��. � <br /> 2.All work ahell be peAormed in eccordanco with Ihis permll and current City ol Everetl Design and Consiructlon <br /> Standerds end Specilicetions. <br /> 3.Call Location Unde�gruund Servlce 4B hrs.belore you dig.TOLL FREE NUMBER 1•800•424•5555. � <br /> , �,�.5 �_F�'miT O <br /> �,a��c, �� �',��o �.. <br /> �,�,� ��r-c�� 1 �/� <br /> �,,«R-`'f V/ <br /> �-� �,�� � ,. � p <br /> �,;,� . <br /> a <br /> /'16� ACY.NOWLEDG[MENT OF CONDITIONS <br /> y The undersigned owneVxpPLcnnt hereby agrees lo hold ond sxve harm� <br /> � �---- less Ihe City ol Evmell Irom any and all cleim5 lor dameges, costb. <br /> e.penses. or causes o� action Ihat may nnse because ol mslallntion <br /> and mamtenance of Ihe improvemenl or o�her nght�ol�wey use hereta <br /> �nn��P� io� and lurther agrees In remova same upon nohce Irom ihe <br /> Approved lor ConsVuctlon pale Gly an�l to �eplace public properry damagad ihereby. <br /> FINAL INSPECTION Dale ' ��.VS1 .� `�I -� ��� <br /> . ` <br /> Approved as Construcled Sign fN� pppcant Oate <br /> everrft PUBUC WORKS DEPARTMENT WOFK AUIHORIZEO BV THIS PERMIT MUST BE STARTED WI7HIN <br /> � 3200CederSlreet 1B0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTEF IS TO <br /> EveralL WA99201 BE OIUGENTIY PURSUED i0 COMPLETION. iHIS PERMIT MAV BE <br /> Phone�.259�BB10 CANC[LLED OV THE CRV UPON ANV STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAVS DURATION. <br /> •__._ - �--� 1 i c�i� , c„ci� ��t7 PCi SP w-v�,� <br /> ,�. -; <br /> , : , J.� <br /> _ �,_-�, _ �`�� e c�� ����r , � <br /> I � J�� l7 /�CFS NC{.�tfS <br /> I/�E /� cF�Fe,�� yL�TnN. <br /> � ' �� � � u �n,1d I�O I <br /> i ( �. ('� I�_ ..��y�,. �� , _� <br /> _ �'lav�C IP� �I accr �5 <br /> , . � ' �'� � —��\ � � Q5�' WtP��.r <br /> � �.,�ZIC�� l � �2 C. CCe � <br /> ; ,, k <br /> ., - � I,�«C �� -�__��I J I P S <br /> .�ti � � <br /> ( ;�`'� t t �' <br />