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Fublit M�OrM�Po�mll� -� <br /> 'ILG1� _ <br /> Biep OaO� • <br /> Dete3�2 <br /> pppllcelion For pu�Lc Woda fee �-�� <br /> WORKS PERMIT TolelPoe <br /> PU B LI C Less�00� �ee Pe�d .-- <br /> B�uncs Dm s��� <br /> Print or Type Only <br /> Everett 98206 347-4347 <br /> pW No. 1 PO Box 1107 Z�P Phone <br /> Snohomieh County cny <br /> Meilin9 Address <br /> Owner <br /> 347-4347 Z�p Pnone <br /> Dennie Coerber �;iy <br /> rnanioe nda�eg5 <br /> APPlicant <br /> Dasc��be Proposed Work add e ui ment Co eubstation at Soein <br /> W <br /> 00 W aeino Rd (747 418nt � <br /> Pro�ect Addresa(��k�oW^� � <br /> • Centerline ot stree� <br /> Atlach tour(4) coplas ol plena lor proposed work• Draw to acele end nole ihe lollowing es eppllce e: <br /> � ProPerlY Lfnes • I����cate North <br /> • Show anY Proposed greding changes � <br /> � p pnp$ed slrul�l�ee on the Ioex1a11ng and � Show measurements <br /> • Ezislin9 and proposed utllitles O <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS � I� <br /> 1.All celle tor Inepeclion shell be mede 24 hrs.�^advenr.e•Phane 259'BB�O� <br /> p,q11 work ehell ba perlormed in accordance with lh{s permlt and currAnl CitY of Everett Deelgn 24 5555ucllon � <br /> Stenderde end Specllicetlona. 7p��FREE NUMBER 1•800'4 . <br /> 3.Cell Locetlon Underpround Service 48 hra.belore you d19. O <br /> �lJ�u.c, LdO71=�J— /"J-iiLtrt�'I" /Vi�� �i°�t��u `` �il <br /> �� , �� N � <br /> 5- a4 �` <br /> I � <br /> � a <br /> � <br /> qCKNOWLEDGEMENt OF CONDITIONS <br /> The undersi8ned owner/eDPlicnnt hereby agreea lo hold and seve herm� <br /> less the Ci�y o' Evere�� �rom enY and ell clalms Icr damages, cosls. <br /> expenses. or ceuses of ection thet mey erise beceuse ol fnstalletion <br /> eppl ed'lor and tu�th1e ea0raesVto eemove 1sameu Pton not ce iromrlhe <br /> Dete Cily and�a replece pubGc proper'y demaged IherebY� <br /> qpproved fo�Construclion <br /> �� Date <br /> �ent <br /> Signature olApp * PE STAF?ED WITHIN <br /> FINAL INSPECTIOtJ y�ORK AUTHORIlED 8Y THIS PERMIT MUS� <br /> qpproved es Construcled <br /> PUBLIC WONKS DEPARTMENT 1B0 DAYS OF DATE PeRMIT IS ISSUED AND THEREAFTER IS T <br /> BE DILIGENT�Y PURSUED 70 COMPLETION.THIS PERMIT MAY BE <br /> � 3200 Ceder Street CANCEILED BY THE CITY UPON ANY STOPPAGE OF WORK ON TIilS <br /> Everelt,WA 98z0� PROJECT OVER 90 DAYS DURATION. <br /> Phone'.259�8810 <br />