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oete 8.s z 9a z9 <br /> Puam won.pvmu. <br /> Applicetlon For e�o.m.. <br /> ' PUBLIC WORKS PERMIT ���W��.f.. <br /> � TW�IFM � <br /> I 4���OVI Po Pu0 � <br /> 0 <br /> � Print or Type Only e.�.�o.o�. • loS2 <br /> OdZ-�Zls�d/��/ <br /> �/fp�oe�rzv Co f O, �oX .3707 /»/s O f-7G .Sea flYe LJn 9 9/Z7 Z6 L -3s6 3 <br /> Owner Meiling Addreae City Iip Phone <br /> S4me. <br /> Appficant Melling Addre9s Clty Zip Phone <br /> Deecriba Propoced Work �7DC� ��e �Qi^7�if_ GY1 1`�iO�f -�/x EX�nn.�ion <br /> ��2 �vulh �n�/ �f' Boa.in4 Cc�.QL[y V � <br /> � <br /> Pro�ett Addreas(II known) .�O 3 C inp � � <br /> Altach lour(4)coples of plane lor piopoeed work• Draw lo etele and note the IOIIOwinp a6 appHceble: � <br /> � Prope�ty Llnae • Canlerline ol etreel � <br /> • Outline end dimenelons ol all eKlatlnp end • Indicete North <br /> propoaed elructures on the lot • Show any propoaed pradinp changea <br /> • Exlsting and nroposed ulilltiee � • Show measuremente � <br /> DO NOT WRITE EIOW TH13 LINE <br /> PERMIT CONDITIONS O <br /> 1.All celle for Inepectlon shall be made 24 hre.In ativance-phone 26�6810. � <br /> 2.All work ehall be perlormed In accordence wlth Jhle permit and cunenf City ol Everett Design enJ Conetructlon <br /> Standarda and Specilicetlonn. <br /> 3.L�AII Lxetlon Underpround Service 4B hro.before you dip.TOLL FIIEE NUMlE111�800�424-86d5. � <br /> � LllOrl� fn � �o�c Pcr�OLQ�,s QP��+v�r• u� or� B-zf'-92 O <br /> � � �'�i<y P��Gc wnr.Es q��o�.` <br /> �' /�Ee/� sf/eC7�1 C lea n r.�' .t!C yirnC S � <br /> a �� �� �_� (��. -_` N <br /> � ��:' O <br /> r.�:: � � ;9�z a <br /> . . .. . _ . .... <br /> CITI' OP C-V�cRET7 <br /> Buildir.❑ Divi;;ion <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The underaianed owner/applicant ha�eby eyrees lo hold and eave ha�m• <br /> ' / less the City ol Everett Irom any and all claime lor damape4 coelc, <br /> _�_L����� � ���Z expensea, or caueen ol ectlon that rnay arise becauee of Inetellation <br /> and meintenance ol Ihe Improvement or other ripht•ol•way use hereto <br /> APP�d Conatr ctio applied for end lurther agrees to ramove neme upon notice Irom tha <br /> Date City end to replace public properly dameped thereby. <br /> Nc,L ^/ � Gatt �/�-9 "�'^�"�' �7Z <br /> Aprroved es Conatructad Signelura ol Applicent Dale <br /> PUBLIC WORK3DE�ART�IENT WORK AUTHORI2E0 BV THIS PERMIT MUSS BE &TARTED WITMIN <br /> 3200 Ced�r Streel 1B0 DAVS OF DATE PERMIT 19 ISSUED AND TFIEREAFTER IS TO <br /> '\ Everet4 WA BB201 BE DILIOENTLY PURSUEU TO COMPLETION.THI9 PERMIT MAV BE <br /> P�one:268•8810 CA�CELLED BV TME CITY UPON ANV STOPPA6E OF WORK ON THIS <br /> PROJECT OVER 90 DAVS DURATION. <br />