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� --T.-- .T-,n—.—a^:r.r— — -. . . _ ._ __. .. - ' ." . �! � °� r —__ , '—. <br /> • . .... ... .. .. , /. . . . . ♦�'� � .. <br /> �8�@ N !0 6 � � ��� • ovbl'c Wad�Pe�mil• 7 O <br /> • Application For I ��nn o�o��• Q— <br /> PUBLIC WORKS PERMIT Pu�i�l�feeF�e : <br /> L�.�AUDI Fee P�iJ 8 <br /> p0 <br /> 9�Ien:eDue 1{ e�r/� <br /> Print or Type Unly �-- <br /> �o�d�nr f �� . �PO/�C iL. ✓'�n�l - � �o r�t� j GU �- �i;'i%;u�i9('� '/r�D �7 i�3 /o�/ln 7 <br /> O ner MaIIIngAtldress City ' Zip Phona <br /> APPI cnnt Malling Addresa Clty Zip Phonn <br /> i J <br /> DescribeProposedWork �11l�u.L � f / (��jn -����� • �- � ;�.(l(�('yr�Rr i� <br /> �p74 �_$1-��sPF� S{�;: �--1-�.-�-'/��, ,� N „7.� -d S <br /> i <br /> i_ � <; <br /> prolect Addresa(if known) ���8 — E Cl�.f/iU0 .f'O.__ ___ � <br /> Aflach four;4� coples of plene lor propnsed work•Draw fo scele end note Iho lollow'ng ea eppliceble � <br /> • Property Llnes • Centedir.e ol strect � <br /> •Outline end dlmenefona ol ell ezleting end • Ind�cele North <br /> proposed etructures on the lot � Show any proposed grading changas <br /> • Exlsling and praposed ulllitlen • S'iow maesuromente � <br /> � <br /> DO NOT WRITE BELOW TIi15 LINE O <br /> PERMIT CONDITIONS <br /> 1. All r,ells lor Inepectlon ehall be made 24 hra In advance- phone 259•8815. � <br /> 2. All wo�k ahell be perlormed In eccordence with thls permit and currant City of Everett Deslgn and Constructlon <br /> Slenderda end Specllicatlona ' <br /> 3. Cell Locetion Underground Service 48 hra.belore you dig.TOLL PREE NUMBER 1•800•d24•5555. � <br /> 11��L/GA•c/!' /S To P^�>!/i'OE PE.c��c7�,Fn��'F O <br /> �t.iD��.�i�-y f�.r' Jn��.i•ouFr.�.E�c•7'T Fi�.�' S��o,�-- ��AT <br /> �ET T' 6'F �Y�i�'�?•' FrrGJ, � <br /> � I <br /> O <br /> a <br /> ACKNOWI E7GEMENT OF CONDIT!ONS i <br /> �he unAeisiyned ownor/epplicant hereby a0rees fo hNd�nd save harm� <br /> less ihe Ci1y ol Everett from ary end all claims for tlamages, costs, � <br /> eapenses, or causes o� ection thal may erise beca�se ol instellalion <br /> �� � �, T`�.�J �/ �< ��� end malntenanco of the improvemenl or other nghi�obway use hereto I <br /> ' ���'� 7� �- applied lor ond lurther ayrees to remove same uPon rolice from ihe ; <br /> App�oved lor Conslruclion Date City end to repluce pubhc properry dameged tha�ebv. <br /> FINAL INSPECTION Uale _L�+"'���� L—_� � �� I <br /> Approved ea Consti�icled Signature ol Applicent Dete <br /> everelt PUDLIC WORKS DEPARTMENT W�RK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHW ��, <br /> iB0 DAYS OF D�TE PERMIT IS ISSUEO AND THEREAFTER IS TO ' <br /> � 3200 Cedar Streol BE DIL�GENTLY PURSUED TO COMPLFTION. THIS PERMIT MAV �E � <br /> Everelt, WA 98201 CANCELLED BV THE CITY UPON ANV SfOPPAGE OF WONKON �NIS <br /> Plione�. 259�8815 pqOJECT OVER 90 DAYS DURATION. <br />