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D818��� ( r�m��wo...ae�mp�u,.� � � p��,-- <br /> Biep Ueo� ��O�J—Wy�-- <br /> Applicallon For � <br /> PUBLIC WORKS PERMIT P��;oW�eFss : — <br /> Lea�oni ieePUC � <br /> eeunce Due S <br /> Print or Type Only <br /> FW 1 1 Pnar�nk� I�n 3 � �n Sy�qa�� E/oinT�- qtf2/y �3 353-/D 53ne - — <br /> Owner Maihng Addresa ���Y Z p <br /> � I_L �_ i� -'l � n � Sn�x ti -- <br /> Applitant Mel6n0 Address �dY Z'P Pha�� <br /> DeecribePropoeedWork COv1M�e��ria LVQI�u/Gu �!�!'1�,T�lC�—S�Nb"�� <br /> W <br /> Pro�ect f.Otlrens(�1 known) .�.��/ } E C(�ri M �_ � <br /> Altech lom(4)copiea cl plens lor proposed wo�k• Drew lo ecale and note Ihe lollowing es applicable: � <br /> • Property Llnea • Canlerline ol street � <br /> • Outlina and dimeneiona ol e11 exlsting end � Show anN�ro g g <br /> proponed etruCturee on the lot y P Posed rBdin chengea <br /> • Exlsling and propoaed utllitiea • Show measu�ementa M <br /> W <br /> �O NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1.All calle for Inepeclion ehell ba mede 24 hrs.In advanca-phona 259•881 U. � <br /> 2.All work ahall be peAormed in eccordence wllh thls permit end current Clty ol Ev�rett Denlgn end Conatructlon <br /> Slandarde and Spectllcatione. <br /> � 3.Cell Location Underprcund Service 48 hra.belore you dfg.TOLL FREE NUMBER 1•800�424•5555. � <br /> + PvBL/C lvv,�s' /3s2r��T .t/oT R�OG�,e.ao O <br /> `��'�,"' � <br /> �-/�-8B � <br /> O <br /> a <br /> AGHNOWLEDGEMENT OF CONDITIONS <br /> The unders�9ned ownaqeppBcenl hereby agroes lo hold end s�ve herm� <br /> less Ino Cily ol Everet� Irom any end ell clelms lor damages, costs, <br /> e■penses, or caueee ol eclion thet mey erise because ol Inelallatlon <br /> and meintenence of the improvement or othe-. righl-o4way use hareto <br /> applied lor end lur�her egrees lo remove seme upon notice Irom the <br /> Approved lor Conslruclion �e�Q City and to replace pubGc propeity dameqed thereby. <br /> FINAL INSPECTION Date Dete <br /> Approved ae Conntructed Signeture ol Applicant <br /> WORK AUTHORI2ED BV THIS PERMIT MUST BE STARTEO WITHIN <br /> p�p�p�� PUBLICWORKSDEPARTMENT 1B0 DAVS OF DATE PERMIT IS ISSUED AND THEREAFTER IS i0 <br /> � 3200CodarStreel BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAV BE <br /> EveretL WA 98201 CANCELLED BV THE CITY UPON ANV STCPPAGE OF WORK ON THIS <br /> Phona:259�8610 PROJECT OVER 90 DAVS DURATION. <br />