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�, � t <br /> i <br /> ,- �,, <br /> �e�e ��, g/ � Publk Wed�Pu�'n)l • � <br /> Appllcellon For BiJp Dept��1.2 G 6�.f�-9-P" S <br /> PUBLIC WORKS PERMIT °�°;e„Fs:°•� . , <br /> , <br /> l.eu 11pp1 F�e P�Itl f ' <br /> Pfl11l Of Type O�lly B�IeM�Due t ( <br /> oE��.�6 �'a ia 13 .370 7 �iS' c�" 7G SE�+rs[E >Si��/ <br /> � pwner Melllnq Addreea Clty Zlp Phone <br /> �. (fLJ AJ<<'� <br /> Applleant � MaIIInB Addreea CIIy 21p Phone <br /> � Deeeriba Proposad Work `'r L�� �✓s s.ee. � r �e .d T�n re e-�S <br /> � qr.fr.d ) <br /> ?R.o.cexr '� /— �� — � �— � `� / <br /> W <br /> . Proleel Addreas pl known) �¢S� � �✓ �'A s�'`�a �'� ` � <br /> � Atlach lour(4)coplee ol plena lo�proposad work• Drew lo ecele end nole the lollowing ea applleeble: �� <br /> ; • Property Linee • Cenledlne ol elreel � <br /> � Outline end dimenelone of alt eMisllnp end • Indicete Nc Ih <br /> proposed etrucluree on Iho lut • Show any propoaed gredlnp chenpee <br /> • Etie11n0 and propoaed utllltlae • Show meaeuremenle � <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> - 1.All calls lor Inepectlon ahell be mnda 24 hre.In advence•phone 259•8870. ^ <br /> 2.All work ehall be peAormed In acaxdence wlth Ihle permll end currenl Clty ol Everett Dealpn end Conal�ucllon � <br /> ' S;enderda end 9pecll�celions. <br /> .� 3.Cell Locetlon Underpround 9ervice 4B hrn.belore you dlg.TOLL FREE NIiMBER 1•800•424•5555. � . <br /> . j��c(.Ld �w��s IZ/Jif'w�/�o7 �yGC.cra'6� � ����, <br /> 6 �,�/ /'{�v// <br /> �-1V�K f7�""�y � i <br /> � ,'.��/y-9� . 'w <br /> _I I', <br /> O I <br /> a . <br /> ACKNOWLED6EMEHT OF CQNDITIONS <br /> tha undoralgneA owner/eppllcanl he�aby egreee lo hold end 6eve harm <br /> —� less the Clly ol Ererell Irom eny and ell clelmn lor damepae, cosls <br /> ox�onaos, or causoe ol ectlon Ihel m�y erlee beceuea ol Inelalln�iun <br /> und melnlenence ol Ihe Improvemenl or othar rlphl•ol�way use hereto <br /> epplled lo� and luither egreee to remove eeme upon notice Irom Ihr <br /> Approved lor Conalructlon Dele City end to repleca public proparty dnmeqed thereby. <br /> FINAL INSPECTION Dxte <br /> Appr��•4d ee Conelrucled Signalu�e ol Apnlicanl Oote <br /> � PUBLIC WORK9 DEPARTMENT WORK AUTIiORIZED BY TIi15 PERMIT MUST BE 9TARTED WITHIN <br /> 3200CederBtreel 180 DAYS OF DATE PERMIT IS ISSUEG AND iHEREAFTER IS TO <br /> Everelt,WA 90201 BE DIlIOENiLY PURSUED t0 COMPLEiION. THIS PERMIT MAY Af <br /> Phanc�259�aHt0 CANCELLfD�V TIIE CITV UPON ANV STOPPAQE OF WORK ON THIS <br /> � f'ROJECT OVCR 30 DAVS DURATION. <br /> � <br /> � <br />