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Daie <br /> PUBLICWORKS P„b,,�Wo,�sP�,m�,� _ <br /> — PERM IT [3uACing Permit r <br /> PIIBLIC VJOHY,S pEPA{71MLN1 Pl;lnning RelarCnr.n< <br /> 320(1 Ce�a� Sucet <br /> Everell.WA 9d201 Pu6he Works Per 5 <br /> IA251257�Bft0 /� ,.. � N �00/ <br /> i �� I'U�IIIIYU...Dr�...�........�...... Guaranleo5 <br /> . ._ _-.. _ _______..__—_—__._ . <br /> ' U17Nf f1 NAME FPPLICANi NAIdE <br /> �� ANU ADf)9C.55 .i j 1 .. ..� ��NO A�ORESS � <br /> i� I II <br /> . . ._.ALl,:: •.r . � �I <br /> � PMONE � <br /> � PNONE . . ' � �:) .. . <br /> '. --___ -___— <br /> —___.__ - -__ __ _._.._ .._'__'—_ <br /> __ <br /> �i TA%PARCELIA/ � PROJEC�ADDfiESS. <br /> ' ,�, . . il (�i�';". '_—_' . .. . <br /> .. .� __ —___—_.__ __.'__ _.__._..—___" <br /> �FSCRIP710NOP i, } .. I <br /> PROPOSEf]WOflN. ' � ' <br /> i <br /> � <br /> PERMIT CONDITIONS � ' � ��� � � ' � �� �� <br /> 1. All ralls lor inspec�ion shall be made 24 hours in advance. <br /> 2 All work shall be perlormed in acwrdance with Oiis permil a�id currenl Cip-of [vere�t Design and Cons�ructwn <br /> St�ndards and Specilications. �� 1 <br /> 3 C.tll Localion Undorground Service 48 hrs. belare you dig.TOLL FREE NUMBER 1-800•424-5555 Yi <br /> � <br /> ��/� <br /> . . . . . . . .y . . i i � VI <br /> [r�oftpF dow�3F•:.uts t�_� the <�cai,. <br /> - , ,�rno���n �,nntrnl Meanuran an �Lr�-. . . _ . � . � . m <br /> 31if 1�-�L7o� 9Cf'dL' hN�.f?:".� .'iVPlo3� ni fTublu❑ ��la+lli:. Tt9 . 4Jr -._ .� . . .t�r��. �:��.. <br /> .�cve ero�ion � .nt�ol meanares upon c�n,:letior� ?: tl�� pesJ'�-`e�ciot�3'S3h O <br /> �1 c�f the Eernit . ''` `' � <br /> 1ict , mud, rock;x „t •tebriy to he trar.kcd .�nt:� toadway. <br /> ,fi 1v��3y fcnm th�r C�ont pr,pecc5• ]in� nut C�, tho atre� pavin9. Z <br /> �FCinlcle� �yst�m is re,�uiced foc this buildiny in ceopl�rncc vit� .h� O <br /> �rentn ��L NFDl� StandarQa 1'D. ;� <br /> + ` <br /> i� � r <br /> '� p�: ...�' � <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> 7 h��unoersigned owner%apph�ant hereby agreos to holtl and <br /> ' savc harmless Ihe Cily ol Evcicn hom any and all claims lor <br /> ��. ��'__,_ ��'_., . _ __._ � '�' � E� �—' .— damages,cosls,exponses,or causos ol acliun ihal may anse <br /> � nppmvM�D�Consiruci�un �O�to because ol mstalla0on and mainlnnanca ol Iho impmvemont or <br /> �� i � �- � / I other nghbol�way use hereto apphep lor nntl lutlher agrecs lo <br /> - i j :� j ��' � remove same upon notice Imm ihe City and to replace public <br /> , . . . . � L �j_�_:.--.___�1—.—_�--1 p�opony damaged Ihmeby. <br /> ', fINALINSP6(i'fION �� , I . <br /> A�q�mvrd aS Consbutlotl Dalo ' . �Y�_�., ' ' . <br /> I . .. �.,r�� ��t..t-;� _: � . . ' <br /> � � Sign.ture ol App6canl' Da�o <br /> WORK'pPlfl�n�ZEDBV"If18PFNM1i�Ml(AN�fl�l(f1�PY�7�CTCIV�UPON9JY�ti1�OPPAGEOFVvOFHONT1/14PROJECTO ERWDAYSIDURA7IONPURSUFU <br />