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;�t:.i�... . . � <br /> /'� <br /> p��a f� 2� 'L we.e wwu r.rmn• <br /> swo.ow�• 3G Y73 <br /> AppliwtiOn For <br /> PUBLIC WORKS PERMIT ~°'�w°�`~ <br /> rar r.. • <br /> uu�oo�r«rNa • <br /> uuna ow t <br /> Print or Type Onty <br /> • <br /> Pl�n Ch�ck No� B ]6�73 e�p1► �o�� <br /> ���� Applio�t.Dat�t 04[93/9� <br /> oob Addr�� 3003 M C116IN0 RD {0-05 <br /> Own�st SOtINO CO <br /> T�n�nlc <br /> Propo�W Up� OI/ICi SPACs Plion� <br /> Applkant D��a. o! Norkt <br /> ALTEMTION <br /> DncrlW Propowd Work OT/IC� 6iT JOs 8ET <br /> �r:' <br /> 11PPNVD lOR PlIIMITt DATS_/_/_ BY ' '�i <br /> W � <br /> PraNet Addnu(If known) � <br /> Atl�M1 lour(4)eoW��ol W�M for propa�d work•Dnw to aal��nd not�lhe followlnp���DP�kaDlr. � �� �';� <br /> • pr���I� •Gnt�dln�of tlnN � .��.;,;� <br /> •Outlin��nd dim�nNon�ol�II�autinp and � Indlc�N NortA <br /> •Ed��dind W uoP�d thlilN •Bhow mnwr� ��m nt,rWinp cA�nq�� <br /> � <br /> PEHMR CONDITIONb O <br /> 1.All pIN la In�cdon�hM b�m�d�24��.In Wwne�•Phon�16�10. � <br /> y AN work MWI pe pNlormW In�na with tAN pnmR�nd ammt City d Ewr�tl Dalpn�nd Con�tn+ctlon <br /> &mdad��nd ep�Ciflntbna <br /> 3.Call Loallon Undnpround��40 M�.bNan You dlp TOLL fll!!NYM�l111�00�4Z460�6. � <br /> �'�i G.tJaz�z.�•a�-C� /va7°�g�cvu�e/ O <br /> � '�,B <br /> y � s 9'Z � � <br /> O <br /> a <br /> ACKNOWLEOOEMENT OF CONDITIONB <br /> Ths undenipn�d owmr/appliunt h�nby apn��to hold�nd ww hamr <br /> I�u th� City ot Ev�rett Irom �ny �nd NI claim� /a d�mp��. ewtR <br /> �Rp�n�a, or uuu� ol �etlon IhU m�y �rlw Wuw� 01 In�tdl�tlon <br /> and m�int�n�nc�of Ih�Improwm�nl or o1Mr riphl•oFw�y uw h�nlo <br /> �OW�ed lor �nd lurth�� �p�e�s to nmow wm� upon notk�Irom Ih� <br /> Apprw�d lor Con�truetlon Dats CItY and lo raD�+ee Dublic Prop�rtY d�rt�pW I��nby. <br /> FINAL INSPECTION ��1° D�t� <br /> ApprovW as ComtrueNd Sipnature ol APPllunt <br /> PUlLIC WONKB DEPARTMENT WORK AUTHORIZED BV THIS PERMIT MU8T BE BTARTED WITHIN <br /> 180 DAVS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> ������ BE DILIOENTLY PURBUED TO COMPLETION.THIS PERMIT MAY BE <br /> Ev�rNt WA i0201 CANCELLED BY THE CITY UPON ANV STOPPAOE OF WONK ON THIB <br /> Pnonr.26?BB10 ppOJECT OVER 90 DAV3 DURATION. ' <br />