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� � - �...,,vw.cim:a:. s � . . ` -'" <br /> oe�e_�s�`XJ P�o,�We,�.�.,�M. 9 D _ yso r! <br /> Appllcatlon For eieo o•a.• ^ ; <br /> � <br /> PUBLIC WORKS PERMIT �b,�;�F� -�. (; <br /> Lau�ppl iq P�Ia /�y /—� <br /> B�I�nts Due { / �"' • ' � <br /> Print or Type Only <br /> II�iO�/�tJ� CoMME2C�AL �2�LaAJF5 P.D• t30X 3707 .5r__�TTi� IUi9 9d�?�z2o7_ <br /> Owner MaiNng Address Cily Zip Phone <br /> BdE/A1G —�1/E12ETTJ7/V/S/ON M�S DN -2q �Ml}X �Aif1HElE�, 3qZ-G648 <br /> Applicent �deltinp Addresa City Zip Phone <br /> DescribeProposedWork C�ovST�2ucT �r F�cr��s�C7��^`�� ��� K'S7�-�"�'1-Q_� <br /> . r <br /> Pro�ect Adtl�ess(il known) �� ��L� u V��:��/� �F SC/T�f/�i PL � <br /> Attach laur(41 cOpie9 01 plBne fof propoeed work- Drew lo sCale and no�a ihe lollowing a6 epplicRble: � <br /> • Prope�ty Linea • Centerline ol slreel � <br /> • Ou�line end dimeneions o!all exieting and • Indica�c North <br /> proposed structurea on tha lot • Show eny proposed grading chengas <br /> • Ezisting end proposad ulilities • Show mea9uremenls � <br /> DO NOT WRITE BELOW THIS LINE A <br /> PERMITCONDITION3 lO/�S/� 11�7/AM ���{4�4 <br /> 1.All cnlle lo�Inepection ahall be m:de 24 hn.In edvance•phone 259•8810. � � <br /> 2.All work ahell be peAormed In ecc rdance with Ihin permit end cur�ent Clly of Everetl DenIp�QQ�tructlon <br /> Standards and Speclllcationa. f548.19 <br /> 3.Call Locallon Underground Service IB hrs.belore you dip.TOIL FREE NUMBER 1-800-��5�4�6.[G � <br /> DPT.20 f323.55 <br /> 7 �c�f•s�'� To �' Lb-v.EE �,F.� F�ioP•eov� pECK 14297.94 O <br /> P�,q.vs t�rc�U 9-a6 -S� <br /> � <br /> � <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersipnetl owner/appllcent hereby aprees to holtl end save harm• <br /> less the City ol Everetl Irom any and all claims for darAeges, costs, <br /> � ezpenses, or ceuees of acllon that mey eriae because ol inelallation <br /> � And main�enence ol ihe Improveme�it or other nght�of-wey uee hereto <br /> epp�iad lor anA lurther egrnes to remove seme upon notice Irom Ihe <br /> App�o �Con cli Dale Ci nd to.eplace public prope�ty Oameged Ihereby. <br /> � � - SC� y�-zs-9d <br /> FI ll SPE tION � Dale <br /> App�oved e6 Conslructed gne�we of App �c � O"I' Dele <br /> everett PUBLIC WORKS DEPARTMENT WORK AUTHO IZ D BV THIS PERMIT MUST BE STARTED WITMIN <br /> � 3200CederS�rpet 180 DAVS OF TE PERMIT IS ISSUED AND TNEREAFTEfl IS TO <br /> Everett,WA 98201 BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAV BE <br /> Phone:259�BB70 CANCELLEO BV THE CITY UPON ANV BTOPPAOE OF WORK ON THIS <br /> PFOJECT OVEF BO DAVS DURATIpN. <br />