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i <br /> � <br /> � <br /> , <br /> I <br /> ' A.�y -z0 • y / <br /> Datel�n�tq�8q r c � �„��,�wo.�.P�,m¢,�.�_ o J_Z/ -- ' <br /> APPliculian �or � � �� � • .._v� ".— �"S�.S __. I <br /> PUBLIC WORK� PERMIT�,� � ' , �:;,°°a-s_J�r�� <br /> Ll1� 190 « �� �..�.,�, s <br /> JAN ll • N�p �o s��— <br /> Print or Type Only - - -• -- <br /> .... . .. <br /> _. <br /> � CITY OF EVF.RET <br /> �C L{-pr Ll�l� N. Nnr�an'�a W�v �' t'w��i33 .36/ -6/SS <br /> Owner Madmg AAdr�— 7 City Zin Phone j <br /> I <br /> . I�N fA)Br�I �n (;�,, o �BR�13�_�nnwr 9� � )78-D171 I <br /> Applicant Maihng Address City Lp Phone I <br /> r ^ __ • ,� ^� <br /> Dascribe Propo5e0 Work �g UN�� /YQ2��Nd_(�p�«pinx - '� <br /> W <br /> P�oiec�nea�ess�n k�ow�i 141 O I,J E ST C A 51 N O KO. � <br /> Atlech low(41 cop�es ol plans(or proposed work� Draw to scale and note Ihe lollowmg as apPliceble� �� � <br /> , • Properly Lines • Centerline of slreet � I <br /> . • OutGne end dimensions of all evsting end • Ind�cate Norih <br /> • pmposed atructures on the lol • Show eny proposed gratling c�anges <br /> • Ezisting end proposed uUlifies • Show measurements <br /> DO NOT WRITE BELOW THIS LINE � I <br /> � PERMITCONDITIONS O � <br /> 1.All calle lor inepectlon shall be mede 24 hra.in advence-phone 259•8810. � <br /> � 2.All work ahall be padormed In accordenca with this permit end current City of Everett DeslBn end Construction <br /> Stenderde end Speclflcetions. <br /> 3.Call Locatlon Underground Sarvice 48 hra.befo�e you dig.TOLL FREE NUMBER 1•800•424•5555. � <br /> � Q...e,- ��r�,-e4!���f ��.�� ,3 -�s �9 o O � <br /> H <br /> 04/06/90 4:34FH OOONR0885 � � <br /> � <br /> q00033282 � <br /> DPT.20 l62.70 <br /> F4JINSP Sx73.41 <br /> PWINSP V-173.41 <br /> PW PC t173.41 i <br /> ACKNOWLED��'1T Qlj��f10NS ' <br /> The undr.rsigned ownedappli�Y7�Q�1eby��i(�hold and save ha�m� <br /> less the City ot Eve�etl IrorL�(and��y§��� lor dameges, cosls. . <br /> expanses, or causes of aclion �hat may erise becausa ol installalion � <br /> � anJ m;�intenence ol ihe Impwvemenl or other righbol�way use hereln <br /> - epplicd for antl lurther emees to remove same upon no�ice Irom the <br /> Appr d G �rucli� a�e City and to replace public property damaged �herehy. <br /> /� , ,� � � - 619D <br /> FI L SPECTION ' Date �" �� <br /> ApproveA es Conslruclad Ignalurc ol Appl p �a�e <br /> WORK AUTHORIZE BY THIS PERMIT MUST BE STARTED WITHIN � <br /> e�P�P�� PUBIICWOHKSDEPARTMENT 1B0 DAVS OF DATE PERMIT IS ISSUED AN� THEREAFTER �S TO <br /> � 3200 Ceder S�real BE DILIGENTIV PURSUED 70 COMPLETION. THIS PERMIT MAV BF_ <br /> Everetl.WA98201 CANCELLED BY TNE CITV UPON ANV�TOPPAGE OF WORh ON THIS <br /> Phone:259�8810 PROJECT OVER 90 DA1'S DURATION. <br /> � <br /> I <br /> � <br />