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oece�G/9t �,,,�wo,..�.,�n. 9 /Z... <br /> Appllcatlon For e�ap.o�q.• i <br /> PUBLIC WORKS PERMIT � °�°�W°^�.F» <br /> ,o�.�F.. • <br /> �.•.eoo�F«wia • <br /> Print or Type Only TO POSTING �e o 5 zoo� �.u�.o�. • <br /> % Bc B,«Eo <br /> '� s$�,oCo. PO Bo.r 97a7 ,n�/s oF-76 Sea7Yle,�i.b, 266 -3SL3 <br /> Owne�T MalNnp Addr ee Cily � z�n Len �, JI Phone <br /> ,�Oh-i <br /> AppHcant Mallinp Addreee CHy 21p Phone . <br /> Oeeeribe Proposed Work �� C�S�i'UC� �irnln�.e l��v(/n� - 02�ei. �. �1�..� <br /> r0 .�tn,� /Y/l r.[J 4�rf� '�il.�k/rt Gsai S!T/! 7b/^ . �Ft]OifL-� . <br /> ;, r <br /> W <br /> Pro�ecl Addrese(11 known) � <br /> Attach four(4�coD�es ol plane lor propoaed work•Drew lo ecele end note Ihe lollowing ae epplicable: � <br /> _ • PropeAy Linen • Centerline ol etieet � <br /> • Outlirro end dimenelona ol ell axiatln0 and • Indicate NoAh <br /> praponed etructwee on tha lot • Show any proposed predlnp changea <br /> � • Exlstinp enA p�oposad utlllifes • Show meesu�emenle � <br /> . DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1.All calle for�nepactlon ehall be mede 24 hrs.In edvance-phone 2b9$81 O. � <br /> 2.All work ehall be perlormed In accordence with thle pe�mlt end currenl City of Everett Den�pn and Conetruclion <br /> Stendarde end Specificetlone <br /> 3.Cell Locatlon Underpround Servlce 4B hro.belore you dlp.TOLL F11EE NUMSE111•800�424563b. � <br /> y, l�Jes./ � /u �.�... �a�,.- `�',f"',�"`�frQa..,. ��aG 7-zf=yr_ O <br /> � <br /> � <br /> � <br /> a <br /> ACKNOWLEDOEMENT OF CONDITIONS <br /> The undereiqned owner/eppllcanl hereby apieee to hold end eeve harm• <br /> lene the City ol Everetl Irom any and ell clelme for tlemapee, cotf4 <br /> expenees, or cauees ol action Ihet ��iay ariae baceuee ol ins;sllatlon <br /> � z7 9Z end meinlenance of the improvement or other rlphFol•way uae hereto <br /> epplled lor and lurther a0�eee to ramove eame upon notice from the <br /> Approve nqj ctio ete City e d to replace public property damaped the�eby. <br /> �� - / d � �r 7 27 <br /> FI L INSPECTION De e <br /> Approved es Conelrucled Slp ure ol Appllcent Date <br /> PUBLIC WORKSOEPARTMENT WORK AUTHOHIZED BY THIS PERMIT MU3T BE STAHTEO WITMIN <br /> 3200CederStreet 1B0 DAYS OF DATE PERMIT IS ISSUED AND TMEREAFTEF IS TO <br /> Everot4 MM BB201 BE DILI�ENTLY PURSUED TO COMPLETION.TMIS PERMiT MAY SE <br /> Phonc 264BB10 CANCELLED BY THE CITV UPON ANV STOPPA6E OF WORK ON TMIS <br /> PROJECT OVER 90 DAN8 DURATION. <br />