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� 'i�F,r;•'��1 .I6T:' .',',Ti.':.•�.�.,ai:.F'. .�7IQ: . . ' ". �s.�-' j'. �, '. .� •. �� .. `..r. ..`.��F"r T _... .� <br /> oe�a M�f�c�l- I�-, �I9P� �' <br /> PuUbc Wo�M�Perm�l• <br /> Applicetion For e�aa oso� � — � <br /> PUBLIC WORIKS PERMIT °°°:a,:Fee�M : — <br /> lee��oot Fe�PuE 8 - <br /> Br'ann0ue s <br /> Print or Type Only <br /> G2A Mc�R� ►n�c_ P o BoX �2?o LyN1JW�b �A 9Bo3(� 7 74,_oo�18 <br /> Owner Melling Address City Zip Phone <br /> CoMrn���c�. G�S►�N ASso<s. ¢Z� l9ur� sT sw LyNu�o r� qBo3� <br /> Appllcent Malling Addresa Ciry 2ip Phona �,/_z�GO <br /> D08Ctibe P�OpOsed Wo�k 7�An►T 1��•`-�'��l/� 4� E�1 S77N�_ 131.�6. To <br /> n�v�oE p�,vrn�,N� ,�.�w tr�,ous + �'AizTiT%oNS ANl� <br /> �NI t,NES �r S pE6+U1�'� �02 A DoNU T S Tb2E _ <br /> Prolect Addreea(il knu.vn) � GA S)Y�/O �� E✓��E � 1 _------ W <br /> � <br /> AI�RCh I(�If(4) coples ol plena lor proposed work•Drew to scele and note Ihe lollowing es applicable: � <br /> • ?roperty Linea • Centedina of street � <br /> • Outline end dlmenalons of ell existlng and • Indicate North <br /> proposed Btruttures on the lol • Show eny pioposed gradinp changes <br /> • Existing and proposed ulllitiae • Shcw measuramenls M <br /> DO NOT WRITE BELOW iHIS LINE � <br /> PER�AIT CONDITIONS O <br /> 1. All calls lo�inepection ahetl h��meda 24 hrs. in advance- phone 259•881 5. � <br /> 2. All work shall be perlo�med In eccordance with Ihis permit and current City ol Everett Design end Consiructlon <br /> Slnnderda end Specllicatione. <br /> 3. Cell location Undorground Service 4B hra.belore you dig. TOLI FREE NUMBER 1•800•424•5555. � <br /> ,l�O �aBGiC �t/ai;�'-s fFri���T .<'F���i,FF.�-� � <br /> �./ 3�y�`�� � <br /> N <br /> a ► <br /> ACKNOWLEUGEMENT OF CONDITIONS <br /> The undersigned owneUapplicent hereby agrees to hold and save harm� <br /> �ess the Crty of Everetl Iram eny and all clsims lor demages, r.osts, <br /> expenses, or cnuses ol ection ihat.mny erise 6eceusr� ol installation <br /> and meintenence ol Ihe improvament or other right-ol�wny use hereto <br /> applied lor a�d lurther agrees to remove same upon �iotice Irom !he <br /> Approved lor Consliuctlon Date City end lo replece public property damegad Ihereby. <br /> FINAL IN9PECTION Date <br /> Approved as Conatrucled Signature ol Applicen� ���e <br /> evrrett PUBLIC WORKS DEPARTMENT WORK AUTHORIZED AY THIS PERMIT MUST BE STARTED WITHIN <br /> 1B0 DAYS OF DATE PERMIT IS ISSUEO AND THEREAFTER IS TO <br /> � 3200 Ceder Sl;eet BE DILIGENTLV PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Everett,WA 98201 CANCELLED BY THE CITV UPON ANV STOPPAGE OF WOfiK ON THIS i <br /> Phone: 259•8815 PROJECT OVER 9U DAVS DURATION. � <br />