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� � G-. -�'�'-S _ <br /> � �� � <br /> � �� <br /> �8�@ J pupbc Wonc�Permll• —� —�� <br /> AppilceNon For eiaa o.o�.._ J _ <br /> PUBLIC WO�iKS PERiIAIT P��IkWorM�(se — <br /> Tot�l;ea f <br /> len�00��Fe�P�IE S,_ <br /> Print or Type Only 8�bece U�e �_��,�n <br /> _�c�a (�ra(.c�a.� 1� 3�3 ' ��. r'u�a� 9�T�1d.J _�.3;3 -Dy:)7 <br /> Owner Melling Address Cily Zlp Phona <br /> Z <br /> __"�J� �.. � .3,..� (�. V��J ���� � <br /> �" -S�3/ - /�s' <br /> pl ant Melling Adtl�esa City 21p °hone m <br /> `C"F' : y'3-,r'8 s/ .. <br /> Deecrlbe Propoai d Work � e.._l�1 . j�j <br /> .. —1 <br /> _ -- . VI S <br /> 0 <br /> m <br /> -- -- ----- -- c o <br /> W �' <br /> �1 /+ O� <br /> Prolect Addreee(If known� _�,31T— C../I I�l/ �C��1� � �� <br /> A�tech lour(4)coples ol plena lo�proposed woik- Draw lo acele and nate the I011owing es epplica6lo: � .. <br /> • Property Lines • Centerline ol strael Q = <br /> • Outline end dimenalona of all existing and • InAlcBte Nor�h N ' —I <br /> prnposed L truclure9 on tha�ot • Show eny propoaed grading thenpee � � <br /> • Exieting and p�oposed utillllea • Show meesurementa �N <br /> C � <br /> DO NOT WRITE BELOW THIS LINE " '*7� <br /> PERMITCONDITIONS O = <br /> t, All calls lor Inapection ehell be n eda 24 hrs. In advenr.e• phone 259-881 5. � m v+ <br /> 2. All wo�k ehell be perlormed in eccordence with thle permi�end current Clly ol F.vere� Design end Construclion O r <br /> Stantlards and SpeciHcAtlona c'� m <br /> 3. Cell Location Underpround Service 48 hrs. belore you dig.TULL FREE NUMBER 1•800•424-5555. � vNi <br /> �' Z Z ft <br /> /�� rYai�L U.C'Gd.ViC /��dTE.".eiiJ� Aul.� �m <br /> ='�. G.�eD�.clls o,u .SiTE To Bf I�a.vF -Sr, TyaT <br /> � � <br /> x <br /> D�e.e��v,aGE Fom ?�1.5 LaT ,DnE_s ,+/or rmvi�CT = <br /> � a <br /> � JU/L.GoU[/D/it.�C /'.c'!'/F�/'T/ES , � � <br /> � <br /> N <br /> 4 2 <br /> O <br /> 1 <br /> /� n <br /> rl `i� r' <br /> i <br />� ACKNUWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicenl horeby eg�ees lo hold nna save harm- <br />� — Iesa the City o! Everelt from any and all claims for Aomeges, cosis, <br /> �� e�penses, or causes of actir that may arise beceuse ol I�stella�ion <br /> �— //' ,P end mninlenance uf Ihe �mprovement or ather righl�ol�wey use hereto <br /> ��__ ��'����� `3 �S epplied lor anA furlher agrees to remove same upon notice trom Iha <br /> Approved la Construc on ale <br /> �/ .. Cily nnd Io�pl�Ce public property demagetl thoreby. <br /> �v�f� � <br /> APP�ov d as Con t ucted Date twe-eFA n :��' , / at�, - <br /> rverelt PUBLIC WORKS DEPARTMENT WORK AUTHOHI2ED BV THIS PERMIT MUSi l3E STARTED WITHIN <br /> � 3200 Cedar Slreel 1BG DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS i0 <br /> Eve�ett,WA 98201 BE DILIGENTLY PURSUED TO COMPLETION. THIS P[RMIT MAY BE <br /> `J Phone: 259�8815 CANCELLED BV THE CITY UPON ANV STOPPAGE OF WOFK ON THIS <br /> PROJFCT OVER 90 DAVS DURATION. <br />