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� <br /> �B�B�� � hs ��<<.�- , • >�;� '"� ',/� 1 <br /> �c �...'" y�- CY'C-�I"� Puoi¢Wark�Permn• <�1•. :7 <br /> Appllcatlon For eiac o.o� • <br /> PUBLIC WORKS PERMIT PuEiKWorw�Fa� _ <br /> Tot�l Faa S— <br /> Leu�ppl Fe�P�IJ f � <br /> B�bnce pue a ' �.nc� <br /> Prfnt or Type Only --7 ! <br /> {� 1 ZSZ 0/S /�{,..... <br /> �\w� `.,�n \`��'Q'� � j�7�.�j �ccrli'lfWn� Lucte� �.20Zi ZSZZ�� / �'k- <br /> owner �— Meiling Address City 21p Phnne � <br /> �.u�. 1 �^-�'fl,�'P"� $cx.�.�-e 0.S� l+,�ooue. Q$Z" � <br /> Applitent Mellinp Addresa City Zlp Phone <br /> DeecrlbeProposedWork 0-�Q f� vC, W0. // O� � ✓e �- <br /> w � � �C /YOkS� 07'� ���c..10.r � <br /> a?' 4 7.? e a�--+rxr e , Dri�e wa. ,g�cc�c o <br /> houSc o-�, s ��1' � <br /> Prol��Addrese(II known) � <br /> Attech lour(4)copies of plane lor proposed work• Drew to scale and note the lollowing as epplica6le: � <br /> • Prope�ty Linee • Centedine of sVeet � <br /> • Outllne antl dimeneione ol ell exlslinp end • Indicete Norlh <br /> propoeed et�uctures on the lot • Show eny proposed grading chxnges <br /> • Exlatlnp end propoaed utlllllae • Show meesurements M <br /> W <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS <br /> 1. All calls lor Inepectlon ehell be made 24 hrs. In advence-phone 259•8B1 5. � <br /> . 2. All work ehall be performed In eccordence wlth this permil end current Cily of Everett Design end Conslructlon <br /> i Standerda and Speclllcatlona <br /> 3. Cell Locatlon Underpround Service 48 hre. before you dlg.TOLL FREE NUMBER 1•800•424•5555. � '� <br /> 1 <br /> I ' O <br /> ij <br /> � <br /> � <br /> � <br /> a <br /> ACKNOWLEUGEMENT OF CONDITIONS <br /> � The undersigned owneqeFPlicenl hareby eprees to hold end save ha�m� <br /> less the fity ol =verett Irom any and ell clalms lor dameges, costs. <br /> expenaes, or causes ol action Ihat mey erlse beceuse ol instaltetlon <br /> ,—�(� - / � � � and maintenence of ihe improvement or olhor right-ol�wey use hereto <br /> '-7�,r�✓ c'n '*-� applied lor end lurther egrees to �emove seme upon notica irom the <br /> Approved lor Conetruclio^-�`le%� Dete CitY nd lo rePlec ublic Y demeped ihareby. <br /> l�� �` ` <br /> ; , s. �-�3-- w-. � 3 � $ �C� <br /> � <br /> FINAL INSPECTION Date <br /> Approved e6 Conetructed Sign ture ol l.pplic n� � Da�e <br /> PUBLIC WORKS DEPARTMENT �'�'�R A THORIZE THIS PERMIT MUST BE STAHTED WITHIN <br /> everett tB0 DAYS OF DATE PERMiT IS ISSUED AND THEREAfTER IS 70 <br /> �) 3200 Cedar Slreet BE DILIGENTLV PURSUED TO COMPLETION. THtS PERMIT MAY BE <br /> Everelt,WA 98201 CANCELLED BV THE CITY UPON ANV STOPPAGE OF WORK ON T� <br /> Phone: 259-8815 PROJECT OVER 90 DAYS DURATION. <br /> L J <br />