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�,� ✓ <br /> Date�:��_����� �,��,�„ w�.•�.,�,�,.�„��Q. ����-- �� <br /> ADplir,:11i0n F�r t�inv oeo� . _n( )_I�-'<J�.. <br /> PUBLIC WORKS PERMIT ----- – - - — <br /> ,,.,,�,�w�,�,��a <br /> ,��.��.P s----- <br /> i..se M,�n r,.va�a S_ ___. <br /> Print �r Type Only �^ �•n„� s'�._ _ <br /> S^�`1Ql � � _r-� �' X,I L NI �O�( JC1 �'� /" 1��. <br /> ,--- �'1� o�c�{� ��d� �'�, � ��'_ �"'1 �_ <br /> —Owner — Mailing Atltlres5 Cdy :ip Phone <br /> �3'"i l 0 C __ _ ___ <br /> Apphcanl Madmg Adtlress City Zip Phone <br /> Describe Proposed Worh `�� � v ����1]..'5.���15�_— <br /> — ,� _ --._'—� <br /> - - - W <br /> Pro�ecl Address lif known� �S— E �AS!if/O ��, _ � <br /> AltaCh fow�4�copiPs of plens lo�p�opo5r.tl work- Diaw lu sr.ale anA note Ihe lollowmg as apPliwAle�. � <br /> • Properly Lines • Cr.nterline ol street � <br /> • Out6ne and dimenswns ol all e��sting anA • Indicate North <br /> proposetl sl�uctures on�he lot • Show any nroposed grad�ng changr.s <br /> • E�isUng antl proposed utilitie; • Show measuremenls � <br /> DC!NOT WRITF BELOW iHIS IINE <br /> PEFMiT WNDITIONS O <br /> 1.All calls for inspection shall be made 24 hrs.in advance-phone :39•8810. � <br /> 2.All wotk ehah be perto�med in accordanr.e with this pe�mit and curren�City ol Fverett Design end Conslruction <br /> Standerds end Specilications. <br /> 5.Call Locatlon Underground Service 48 hrs.before you dig.TOLL FREE N'�MBEn 1-800•424•5555. � <br /> I' CL'1r2�.�G°� .:X�cc.,�4C/.=�- �;_'/,`�C ,:�'..�-'f.t.:.le-� �"�� ,/ ��.- . � <br /> � <br /> ' �/, -, > <br /> �.cl� 5��,-c7�t"�' Jf'� � <br /> .`� ,�,t^.on/�'7k_ Cu.zh .�' ,�'Tc�L—c. 4.f cl/1c.[rec�.�� �e�-Aa��'�✓ <br /> !/+�tT' .ln17!/� � � �' >/. � <br /> ��i«�r«�a'��z <<f� .�=�,..I���I .3�'.' O <br /> ,. � � � � , . � <br /> G' - ��c �'�^„ Y� � �'l.✓��.�/ ��' +t<��" �^L Ld �'�'�:'. :..� �.:";: ��� i,c�i, -:�Ei�"' , <br /> ACIWOWLEDG[MENI OF CONDITIONS <br /> The untle�siqned owneUapplicant here6y agrees lo holtl anA save harm� <br /> —"-----�—""-- Iess Ihe Cey ol Everelf trom any and all claims Inr damages. cosls. <br /> • I e�penses, or cause� of aclion that may anse becausn ol inslalla;�^n <br /> �_ / G. �— �nd mau�lenance ol Ihe irprovement or othe� nyhPobway use hn�elu <br /> � // �" ���'"r'-�- /-��_ apphed lor and �urlhNi agrees lo remove same upon nohce irom Ihe <br /> ApproveA lor ConstrucGon Dale Cily a��d to repl..ce Pu6hc property tlamaged Ihereby. <br /> �A ' )��—G��7L�� ���<< ' -2����1�z--�`L <br /> Af�Proved as Const;��cled i9nalCre ol A L ant D.ae <br /> evrrett PUBLICY�ORKSDEPARTMENT WORK AUTHOHiZ[D BV THIS PERMIi MUSi BF STARTEJ V.'I':�IIJ <br /> �� 3200CederSireel 1p0 DAVS OF DATE PERMIi IS ISSUED AND THEREAFTEF IS TO <br /> Everetl,WA9A?Ot BE GILIGENiLV PUPSUED TO COMPLETION. THIS PER�d1T MAV BE <br /> Phone�259�BA1b CANCELLED�V THE CITV UPON ANV S70PPAGE OF WORK ON THIS <br /> �� f ROJ[C1 OV[H 90 DAVS DURATION <br />