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�8t8_�� � I Po��¢WorM�Psrmil• `� / _ �— <br /> / � <br /> Applicetlon For e� oeo� • <br /> RUBLIC VISORKS PERMIT ���To�nisa�ea � <br /> Lao�oo�Fea PuA � <br /> Print or Type Only en.��.o�a s a�— <br /> P ��7 _S�und �� ( L( �l� z wc� , � � c �Yl.� ,��� <br /> Ownar Malling Atld�esa City 2ip Phone � �jlt�- <br /> �,�D '� / ' /y S.� /� �C� � t=. U t /ZETT l�� . � S�o� <br /> r b�!� Y �' <br /> Applir.enl Malling AdAiesa City Zip Phone <br /> ��oe17y3 9.�s� <br /> OeacAbe Pioposed Work �i'�E �.F/vEaJA�/ GYJT TU C 7�/ if' /�.G✓. _ <br /> PE� U.S,s f��ern�r 'df7- 66 _ <br /> - W <br /> Pro�ect Addreae(II known) !��2� — �AS/�J� � <br /> httech four(4)coplee ol plene lor p�oposed work�Oraw lo scale and note Iha lollowing as epplicable: � <br /> • PropeAy Linee • Cenlerline ol street � <br /> • Oulline end dimenslone ol �II exlatinB en� � Indicele North <br /> p�oposed BIruClu�es on�he lo� • Show eny prOposed giading chengas <br /> • Exlatinp end propoaed utllitlen • Show meesuremenlc � <br /> DO NOT WRITE BEL04V TNIS LINE O <br /> PERMIT CONDITIONS <br /> 1. All calle lor In9pectlon ehell be mede 24 hre. in edvence• phona 259•881 S. � <br /> 2. All w�ork ahall be periormetl In eccordance with ihis permit and current City ol Everett Uesign and Construcllon <br /> Stendardn end SDecificalions. <br /> 3. Cell Locetion Underground Service 48 hrs.bebre yau dig. TOLL FREE NUMBER 1•800•424•5585. � <br /> O <br /> ' �� �Z��9� � <br /> �"�� <br /> 1�1� i � <br /> �}}�C�`� `y (��� � �C`� �oiio�is� ii:saa�, �oaa�s �x� <br /> /�� ` dka/�-�J "G.tn� � <br /> �� � � oFwr� szo.00 a <br /> � ����� c�a; :zo.00 <br /> � <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The underalgned owner/eppllcent hereby egrees to hold end sove harm� <br /> lass the Clty of E:eretl Irom eny and all claims lor demeges, cosls, <br /> expenses, or ceu9e: ol ection Ihat may ariee 6ecouse ol inst&Ilalion <br /> � p and meinlenance ol the improvement o�olher �ighl�ol•way use hereto <br /> � npplixd lor and Iwiher egrees lo remove same upon notice Irom the <br /> A proved 1 C �tru ti n ^ Date City erid lo replpca public property demeged thereby <br /> ���7 � n ` ' 1 ) � <br /> FINAL INSP[C ON Date �\��\1 . <br /> Approved ea Consirucisd Sign lu� re ol Appfl�ent ^ Dete <br /> evrrett PUBLIC WORKS DEPAHTMENT WORK AUTHORIZED BV THIS PERMiT MUST 8E STARTED WITHIN <br /> � 3200 Cednr Street 180 DAVS OF DATE PERMIT IS 1£�UED AND THEREAFTER IS TO <br /> Everetl,WA 98201 BE DILIGENTLV PURSUE� TO COMPLETION. 7HIS PERMI7 MAV 9E <br /> Phone�. 259 8815 CANCELLED BV THE CITY UPON ANV STOPPAGE OF WORK ON THIS <br /> PROJECI OVER 90 DF.VS DURATION. <br />