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i <br /> � <br /> � <br /> i <br /> � x �-ze -> <br /> (� ���) f � � <br /> D8►@_(_f.L/( �n c of �v v�ei��woa.oe� . c.� <br /> Applicetlon hor amn ono� �_ <br /> PU�IC WORKS PERMIT PoblroWod�iea <br /> � Toblfae d <br /> PrintorTypeOnlyx ��pyy�.�;� 8 �N8 � 1-. .P•1a ��r-- <br /> � N �N� � � M J <br /> � �C Y /C�l 11.1,AW A' � M M �1J_].CL1__ <br /> � Owner � ��� e ees.-r}_S City ip Fhone <br /> �n [.,�. N W <br /> .�ti � <br /> s � � � q8�D �08-.-� <br /> Applicent Malling Addrr.ss City Zip Phone <br /> Deecribe Propoaed Work � 1 V�—{ J�� ��A � — <br /> W <br /> Pro�ect Addrese Ilf knownl � <br /> �-o�r <br /> - Aflach lour(4)coples ol plana lor proposed work• Drew lo ecale and nole the lollowing as epplicable: � <br /> , • P�operty Linea � Centerline ol sireet � <br /> •Oulline end dimenslons of ell exlsting end � Indicale North <br /> � p�opoaed siructures on Ihe lot • Show any proposad gieding chenBes <br /> � Exlatlnp end propoaed utilitles • Show meesurnments � <br /> DO NOT WRITE BELOW TNIS LINE O <br /> . PERMITCONDITIONS <br /> 1.All celis lor Inapectlon ehall be mede 24 hrn.In edvance-phone 259•881 O. � <br /> - 2.All work ehall be pedormed In accordence with thie permit end current City ol Everett Design end Conatructlon <br /> Standarde end Specllicetions. <br /> 3.Cell Locatlon Underground Service 48 hre.belore you dip.TOLL FREE NUMBER 1•800-424•5555. � <br /> O <br /> � <br /> � <br /> o I <br /> a � <br /> ACKNOWL[DGEMENT OF CONDITIONS <br /> The undersignrd awner/epplicent hereby egrees to hold end seve haim� <br /> less Ihe City ol Everet� Irom eny end all claims lor damages, cosis, <br /> .� �� 'L' � / ezponses, or causes of ac�ion that mey ailse beceuse ol inslellation <br /> i ' � .!. ��GG 7 ��/p� end meinlenenco ol Ihe improvoment or o�her �ighbol•way use hereto <br /> ��� ��� � applied for and luriher agrees lo remove eama upon no�ice Irom ihe , <br /> Approve r Cqnslrucl�o � �a�e City and to replace public property damagad ihereby. <br /> � ?�i��f L)LLc�,�JcE �.}:��1� � /�d I <br /> FINAL I� Dete �'� <br /> Approved as Conalructed Signeture ol Applicant �� I <br /> evereft PUBLICWORKSDEPARTMENT �YORK AUTHOq12ED BY TNIS PERMIT MUST BE STARTED WI7HIN I <br /> 3200CederSireet 180 DAYS OF DAtE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> �� � Eve�etL WA982o1 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAV BE <br /> Phone:259•BOtO CANCELLED BV THE CITV UPON ANY STOPPAGE OF WORK ON THIS � <br /> 1 V PROJECT OVER 90 DAVS DURATION <br />