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� <br /> � M{�Ikatbn Fa 1'��L{a�f _ <br /> PUBLIC WORKS PERMIT °e�e_ <br /> ��.�� � <br /> �" �UBLIC WORKS DEPARTMENT Publw Worke Partn;R _�S�__ <br /> 3200 Cedar Sireet <br /> Everatt,WA98Y01 259�08� � j 1�r / <br /> Huilding Fermlt N_y�p.�. <br /> TYPE OR PR�NT qNLV jp POSTI N 6 Publ�c Works Fea S �iQ!_— __ _ <br /> J�� R;� ��� ��_� � q� �� �3�T <br /> Ownar Mailing Addre:is City I� Phone <br /> QW►�JI� <br /> Applicant Mailing/lddrass C8y Zip Phone <br /> Describe Proposod Work � �1�� ■ ■ ■ <br /> W <br /> - - � <br /> ,. � <br /> r�� � "� �" � <br /> PROJECT ADDRESS(if known) 77�2 G• �iSiVlfi Ic.d, f.W^r � ��8 � <br /> .4itach lour(4)coples ol plans Por proposeA work-D�ew to acale end note the lulbwing I}applkeble: � -� <br /> •i'roparly lJrros �OWline and dimenslons of ell e■Isting end proposed structures on the lot 'Erlstlnp and proposed utiNtles O <br /> �Centerlina ol etreel •Indicate North 'Show any proposed gradinp changes 'Show meeeuraments � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIpNS: � <br /> 1. All calls for inspectlon shall be mede 24 hours in advance- phone 259-8810. � O <br /> 2.All work shall be peAormed in accordance with this pertnit and current City oi Everett Design and <br /> Construction Stendards and Specifications. <br /> 3.Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 7-800-424-6666, � <br /> � fn•tnll nn uifilhntion tr��uch built n� ��rr SecUon ).2.6.? iwcl Pigure suid'I�nhle i-?.? ot thc cdy � <br /> �ion�i�au�•� �tsw�cem,•ut nt�munl (copy'ti �t�q�led to �hie penuit). 'ihe intiluntion treuch �h.ill l . O <br /> uo �loser tli;w � f���•I lo any up slnp� properi}• liur or fnimdalion nor closrr Ih;ai ln lerl lo smy � <br /> Jn„n.ln�ic nro�n•it�� linr �a fouudxlio�� i'all Public 1�'orks for fm inspcction prior lo cm�et'inc <br /> n �nc•hr�. <br /> �lm rne,ineer for Ihi� �hori pl;rt hns detern:incd Iliat thc Irencb dim�nGinns .hould b; <br /> �� II,IxJ..S'IK'lx3'(I�I <br /> � �dhrn� to Ih�• oilv'�• •-m;dl �r,irr�•I l,�ct m,m�g��m��nt prnctico� nr �lated in sechon 2-2 2 nl'Ihe cilv <br /> I�. :�rn ;inil i 1ai.tniclini� tiltmd;ud. :ind tip�cilicidiona :i�r 1)���clopmen� (�dtuchrdl <br /> l�/1 0{� <br /> ACKNOWlEDOEMENT OF CONDITIONS <br /> � � �/�/`� The underspned owner/applfcant hereby aprese to hdd arM seve hmmleu <br /> 7 the Clty of Eve�etl Irom any and all clalms fa damapa�,coata,eapenxs,a <br /> ApP vetl/or Construetlon Da e causes ol aetbn that mey erne becauae ol Installatbn end melntanenee of <br /> the Improvernent aother rlpht-o/-way ux hnato applled fa and lurlf�er,preee <br /> to�emove eama upon notke from tM CNy end to replace pudb property <br /> _ �• �. ♦ �i—.z—95' _ darnaqed thereby. <br /> FINAL INSPECTION pe�e �� <br /> Approved as Constructed <br /> ��'�7't Y. <br /> Slpnatureo An;Akanl Date <br /> WORk AUTHORIZED BY TNIS PERMIT MUST BE STARTED WITHIN 1B0 DAVS OF DATE PERMR IS IS'�.�D AND THEREAI-lER IS TO BE WIJOENTLV WRSUED TO <br /> COMPLETION.THIS PERMIT MAY BE CANCELLED BV THE CIlY UPON ANY STOPPA6E OF WORK�,�J THIS PRQIECT OVER 90 OAYS WRATION. <br />