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1 <br /> _..l <br />� oece��1[� 3 P�e���Wo�, rmll• <br /> Applicetion For eiaa oeo��• <br />� PUBLIC WORKS PI:RMIT PueTo�F�eFaa <br /> ' leu�00�F �10 S � <br /> • B�I� ua { <br /> PNnt or Type Only �.�,T ��� y � <br /> �O�G{�� aIIInB�ss " V/i"`� G� /� ZQ � �nJJ ' / 7�/ <br /> Q��Gw � ��us?.Ma�����da a '�G����� 9�'zo3 �.s��Z�z� <br />� Oeacribe Proposetl Work �fi ��ZG / ��,d� v ' �' ������ � <br /> I <br /> W <br /> Pro�act Addreea(11 known) � <br /> Atlech lour(4)copies ol plans lor proposed work• Draw lo acele and nole Ihe Iollowing ea app�iceble: � <br />� • Prope�ry Lines • Centerline of sireet � <br /> • Oulline end dlmenalona of all existing and • Indicete North <br /> propoaed etructures on the lot • Show eny proposed Brading chenpea <br />' • Exlslinp end p�oposed utilities • Show measurements M <br /> W <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br />, t. All celle for Inepecllon ahell be made 24 hra In edvence•phone 259•881 5. � <br /> 2. All work ehell be perlormed in eccordence with Ihla pormit and current City of Everett Dealpn and Conetiuction <br /> Stenderda and Specllicetlona <br /> 3. Cell Locelion Underpround Servlce 48 hre.belora you dip.1'OLL FREE NUMBER 1•800•42¢-6�65. � <br /> � 1 <br /> � c <br />� � k� I� L �� ! (�l � rC � O <br /> b � ,��s � <br /> , <br /> �� r� �, _ � " � 3 O <br />� � ��'�"' a <br />� � � °� <br /> � ACKNOWLED6EMENTOFCONDITIONS <br />� The undersigned owner/epplicant hereby eprees to hold end eave herm- <br />� lesa Ihe CitY of Evarett from eny end ell clalme lor demage& coet& <br />, expenaes, or ceueee ol acNon Ihet mey edee beCauee ol Instellatlon <br /> end meintenence ol the improvement or othe�ripht•of•wey use hereto <br /> eppllad lor end IuAher egreea to remove seme upon notice irom the <br /> t App�oved lor Conalruction �BfB Clty end to replece public property demaped Ihereby. <br />�I . <br />� FINAL INSPECTION Date <br /> Approved ee Consl�ucted Slgneture ol Applicent Dete <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> everett PUBLIC WORKS DEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> � 3200 Ceder Street BE DILIGENTLY PURSUED TO COMPLETION.TH18 PERMIT MAY BE <br /> Everetl,WA 98201 CANCELLED BV THE CITV UPON ANY STOPPAOE OF WORK ON THIS <br /> Phone:259-8815 pROJECT OVER 90 DAYS DURATION. <br /> f <br />�- —. .. . . - - -- <br />