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� /�_��.. .._. PuEM1c Wo�h�Po�mil s U/ — �`� " • <br /> DetB� emc oao� • <br /> i <br /> Apptication For <br /> PUBLIC WORKS PERMlT PubTol�Foef�a • <br /> Le���OC�FeaP��C S._.��j � <br /> B�i�nro Due S GQ� <br /> Print or Type Only <br /> � aGes'r�v 1�'a5- C9��f' ��c�f�r 98zo/ <br /> Owner Mailinp Addresa City Zlp Phone <br /> ���� City Zip Phone <br /> Applitent Mail�np Address <br /> �oscrlbe Proposed Work CGrC>S7�C�dfT �— y�r�FF.c�GE – <br /> �gLo.vG .G-',•4C.f" UF S/oEkI�JL�' Oi1J CE7GiF A/�L�. _ <br /> .t/� �i c vnl�r L � <br /> Prolect Addreae IH known) ��-�OS- !JL/ 4' � <br /> Attech fou� (4) :oples ol plene for proposed work- Draw to acele and note lhe following as appliceble: � <br /> • Pioperty Llnee . • Centerline ol streot � <br /> • Outline end dimeneiona ol all exlsting and • Indicate North <br /> propoaed strucluren on the lot � Show eny proposed gradlnB chanqns <br /> • Exleting end proposed ulililles • Show measuremants M <br /> W <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1. All calle for Inspeclion shall be mede 24 hra In advance•phone 259•887 5. � <br /> 2. All work shell be pertormad in accordenc� with thia permit end current C1ty of Everett Design and Conetruction <br /> Standerda end Speclllcallons. � <br /> 3. Cnll Locatlon Underground Service 48 hrs. before you dl��.70LL FREE NUMBER 7�800•424•5555. <br /> O <br /> � <br /> � <br /> ,,,. 'il'r ._ .".,i'i�� Ui��J:�NLO>7 � <br /> / <br /> ;�,,;„�oa�s a <br /> :1, .:o :�u.c� <br /> �i:!- g:U.uO <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The unde�signed owner/aDP�icant hereby aBreea to hold and save herm- <br /> less the City o� Everetl irorr� any and ell tleims lor dnmages, cost& <br /> expensos, or causes ol ection that may ariae becauso of inntelletlon <br /> ���� /– ��?� and memtenence ol the improvement or other riqht•ol-wey use hereto <br /> �6y � applled for and lurlher egrees to remove same upon nolice Iwm the <br /> Approved lor Co stc ct D81e City end to replace nublic property demeged thereby. <br /> i / _ / /� �, ,? � �`' �� <br /> dl�i F��' �7 C��-��f` /-�r ��,�%T�(/��� <br /> FINAL INS�E-CTION �01e Dale <br /> Approvod es Conatructed ignnture of plicant <br /> �YORK AUTHORIZED BY THIS PERAtIT MUST BE STARTEO WITHIN <br /> everell PUBLIC WORKS DEPARTMENT 1B0 DAYS Of DATE PEH�AIT IS ISSUED AND THEREAFTER IS TO <br /> � 3200 Cedar Street BE OILIGENTLY PURSUED TO COMPLETION. THIS PERAt1T MAY BE <br /> Everetl,WA 98201 CANCELLED BY THE CITY UPCN ANV STOPPAGE OF WORK ON THIS <br /> Plinna: 259�8815 PROJFCT OVER 90 DAYS DURATION. <br />