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--• ---- - --- - . _ - -- . - . - --- --,..�..,,r-- ----.r-�1 <br /> � ^ � <br /> C1AtA B/6/90 n„ne�wm�.v�,mn. —__ <br /> e�nc oeoi • �➢/.2529fi— <br /> AppGcetlon For i <br /> PUBLIC WORKS PERMIT PuM¢WmM�Fee s_ — <br /> .o�.�«� <br /> j� ��ssnnN r..va�n S � <br /> e�i.,���o�� S_ I <br /> Print or Type Onry j <br /> � <br /> Aoqar Aathbun 914 S. Ce�ino Dc Evoratt 98203 _ 347-1628 <br /> Owner Mailing AAdress Cdy 7in Phone <br /> ONI1�Y __ — <br /> App'iCen� Mxiling AdAress r��y Zip Phone <br /> Deecribe Propoaed Work New a�O� — -- <br /> - W <br /> Pro�ect Addrese 111 known� 91d E. Cse17f0 Y11. _ � <br /> Altach lour(4)coolea ol plans lor proposed work-D�ew to sr,ale and note the lollowing as tipPlicable�. � <br /> • Prone�ty Linea • Centerllna ol stroet /A <br /> • Oulllne and dimeneions ol a�l existing anJ � ghow any proposetl pratling changes Vr+ <br /> proposed structures on the lot � Show measuremenis M <br /> • ExlstinB end proposad utllitles <br /> W <br /> DO NOT WRI7E BELOW THIS LINE O <br /> YFRMITCONDITIONS �,`��� <br /> 1.All calla lor Innpectlon ahell be made 24 hra.In edvence-phone 25P•8810. . � <br /> 2.All work ehell be perlormed In eccordance with this permit end c��r�ent City of Everatl Dealgn end Construction <br /> Standerda end Specllicatlone. <br /> 3.Cell Locallon Underground Service 4B hrs.before you dig.TOLL FREE NUMBER 1•800-424•5555. � <br /> O <br /> ��!/Y-cG� �(J�iI���.;..��� � � <br /> hA/ �����`{•��^'� . . , � <br /> `��;,' /�rr•Y� O <br /> s /7•9� <br /> a <br /> ACHNOWLEDGEMENT OF CONDITIONS <br /> � The undersigned owner/applicant hereby agrees to hold and seve herm- <br /> less the City ol Eve�etl Irom eny and all cleims for damaBes, cost�, . <br /> expenses, or causes of action thal may erise because o1 instellalion ' <br /> and maintenance ol the impwvement or other righhol�way uae herelo <br /> eppGed lor end luriher agrees to removc same upon notice Irom the <br /> l�pproved for Constructlon Dale City and to�eplace public property damegbd the�ebV. <br /> S � <br /> ��FINAL INSPECTION Date � De�e <br /> Approved as Construcled SignaWre of Appllcant <br /> WORK AU7HORIZED BV THIS PERMIT MUS7 BE STARTED WITHIN <br /> everett PUBLICWORKSDEPARTMENT 180 DAYS OF DATE PERMIT i5 ISSUEO ANO THEREAFTER IS TO <br /> I � 3200CederStreel BE DILIGENTLV PURSUED TO COMPLETION. THIS PERMIT MAV BC- <br /> Everet4�^1A 9820� CANGELLED BY THE GTV UPON ANV STOPPAGE OF WORK ON THIS <br /> Phona:259�BB10 pROJECT OVER 90 DAVS DURATION. ,� M <br /> _._.J"'—___s <br />