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Date�9D� 9D— j9� �-- <br /> PUUI�c Worh�permll� <br /> Application For eaq o•ot.• <br /> PU IC WORKS PERMIT w r�;;�;��» � <br /> Lan�oo�F�� P�a / <br /> Print or Type Only� S 8 e.�.,�.o�. � 9Soo <br /> P � � TO POSTING_ 3-30 -�� oa2 32�-yo _aoo_,,_B3� <br /> , y <br /> Owner � F � MalNnp Adtlresa Clty Zip Phone <br /> �yy. ' C <br /> �Yl� � ��Yn �GS�'hn 2.1 �= I �S( � <br /> Applican MalHnp,vaareas Clty Zip Phone <br /> D!lcrtb!Propoe9d WO�k �pg��'/ W(�d e„ ��ns—sa►t�r..� Y'�C J <br /> v �+ J <br /> rt�Oca�f.,c F�vice . <br /> Pro�ect Addrene(II known) pUD S UPf�TM . p _ � <br /> Aflech tour(4)coplee ol Dlnne lor propoeed work-Drew lo acale end note the lollowinp es appHcable: � <br /> • Property LInAe � <br /> • Centerline ol elreal � <br /> • Outline and dimenalone ol all exlaBnp antl � Indicate NoAh <br /> proposed structures on the lot • Show any proposed pradinp chenpea <br /> • EKletinp�nd proDosed u1111tiee • Show meaeuremente <br /> O N WRI EL W THIS LINE � <br /> PERMIT CONDITION9 O <br /> 1.All c�lle for inepectlon shsll be mada 24 hre,In advence•phone 2Sa89/0. � <br /> 2.All work�hdl ba peAormad In accordance with thls pe�mit and cunent Clty of Everott Deeipn and Conetructlon <br /> 8t�nderd��nd Bpeclflcatione. <br /> 3.C�II Locatlon Underpround 8ervice�B hro.before you dip.Tt►LL FIIEE NUM�E111•800�4Z458SS. <br /> f� G�o�.to .fa� d.o,.� � �`z �°-f'm"�' af%°'2oveo� � <br /> � ��u6�1'w Cc�o,/h ��-7;- a,,� O <br /> � <br /> � <br /> O <br /> a <br /> ACKNOWLEDOEMENT OF CONDITIONS <br /> The underelgnad owner/epplicent heraby aprees to hold end eeva harm- <br /> lens the City ol EvereU hom eny end ell clalme for demapee, cnete, <br /> expenaea, or caueea ol ecllon thel may ariae because ol insta!letlon <br /> ��E,�y`_ O and malntenence of the improvemenl or other rlahl•obviey uee hereto <br /> Approved for C na vclion applled lor and fur�har apreee to remove eame upon notice Ir�m the <br /> a�e City and//to replace publlc property damaped thereby. <br /> � � ��:�l•G1a%a°G • B ,P.�n <br /> � � ,�'�� ���, ��..., f�� �r <br /> FI ALINSPECTION' � ' Dele �- � ��� ..� fG�/flv'!� rJ`2•5�0 <br /> Approved as Conetrucfed Slgneture ol A Ilcant 7 Dale <br /> everett PUBLICWORK3DEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STAqtED WITHIN <br /> � 3200Cede�Streef 1B0 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everott,WA9B201 BE DILIGENTLY PURSUED TU COMPLETION.THIS PERMIT MAY BE <br /> Phone:2bB�8810 CANCELLE�BY THE CITV UPON ANV STOPPA6E OF WUIiK ON THIS <br /> PROJECT OVER 80 DAYS DURATION. <br />