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/ <br /> �e�e� Pu�li[WO�MpPllml�� _ _ <br /> Applicatlon For ema o.o� •—g��G��_—_ <br /> PUBLIC WORKS PERMIT PVnTo��Fee�ee = -- <br /> Leulool fe�VUC f <br /> Pflnl Of Type Only e,�.��e o�e t _ <br /> (�.T�F A�r,r-��u1� � IN!' ��,�m3 �VP/0� ����o <br /> Owner Melling Add�esa Cdy 2ip Phone <br /> Applicent Malling Address Cdy 2ip phone <br /> Daecrlba Proposed Werk _ ��.y(�,���� ��1r�*��p��� _ +T� Y y�L /C(�,�/� <br /> - -- W <br /> Pro�ecl Addrees(II known) - � <br /> Altech low(4)copiee ol plana lor praposed work- Draw to ecale and note the lollowing as applicable: � <br /> • ProDerty Lines • Centerline ol alreet � <br /> • Outline end dimensions ol all eMistind end • Intlicete North <br /> proposed elrur,turee on the lot • Show eny p�oposed g�eding changes <br /> • Existing end proposed utllities • Show measurements � <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIOI:S <br /> 1.All calle for In••actlon ehell be meda 24 hra.In edvance-phona 259•8810. � <br /> 2.All work ahall �e pedo�med in eccordence with thls permit and current Clty ol Evere�t Design and Conalructlon <br /> Stendmdn anA Specificatiune. <br /> 3.Cell Locallon Underpround Service 48 hre.before you dig.TOLL FREE NUMBEN 1-800•424•5555. � <br /> �L���. P...��.:��'��,:�����s-B8 O <br /> H <br /> V� <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/npplicanl hereby egrees to hold and sava he�m� <br /> - less Ihe Ciry oi Everell Irom eny and alt cleims foi demeges. cost& <br /> ezpenses. or ceuses ol nciion ihal mey arise beceuse oi inslallalion <br /> end mnintenence ol the improvement m olher nghl�of�wey usa hereto <br /> applied lor and further ng�ees to remove sam� upon notice Irom Iho <br /> Approvetl lor Construcllon Date Clly and lo replace uubhc oruperly dameged Iharaby. <br /> FINAI INSPECTIpN Dete <br /> Approved aa Conatructed Signaluie o�Applicant Dete <br /> eve�ett PUBIICWURKSDEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUS1 BE STARTEU WITHIN <br /> � 3200CeAer5lrea� 1B0 DAVS UF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Evorelt,WA 98:01 BE DILIGENTLV PURSUED TO COMPLETION.THIS PEfIM1T MAV BE <br /> P�one�259�0810 CANCELL[�BV THE CITV UpON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />