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. __-_—___ _ . _ . <br /> oe�e r � /�+ a Pu04[WorM�Pum�l�_ f�S Z /� <br /> ppplicallon For ..� e�na o.o� •_ __ <br /> r� <br /> PUBLIC WORKS PERMIT PUM¢Won�fee - <br /> :r Touir.e S <br /> �� l ea�oa� i.e Pn�n S_�_ <br /> f5 <br /> Print or Type ONy , � �; e.�.���o�o s— 4' � <br /> t� �r ., h r/ <br /> /.�� , �,� �� <br /> n/�S�N ,Z4� s,�ti �'s�:�.�s Rl s��� bs�—� , q , <br /> Ownei Maiiinq qqdress �` t ; - Zin Phonr. <br /> r., �; <br /> ` ( :�� �� � ,:, <br /> +YDo..-�— .�� � i�, ;; <br /> .� <br /> APPficent Ma�linq AdA�c7s CAv --_--Lp Phc ne -- <br /> \ ( /� � - '1 <br /> Dee[rlbe PropoSed Work _ �� i1 ��'�� � I O� � � " —�.�--l.�}-- <br /> ' ____.- ._'-_— __'_ I —__ <br /> —_—_—_ __ <br /> ._.____._______'_. <br /> DZ Ot. �v e,rCte� - , W <br /> — --- - -- <br /> - --- - <br /> Pro�ect ADAress U�knownl ____�_1�__C_ S � <br /> Atlach lour 14)copie9 0l plans Im proposrd wurk � D�nv: In >r,d•• .�nn nn�e m„ fonowmg as anu��r.ab�e. <br /> � <br /> • P�onerty L�nes • Cen�e�hne nl streel � <br /> • Outhne and dimens�ons ol all enstmg and • Intlicale Nor�h <br /> proposed structures on Ihe loi • Show any nronosad prntling r.hnnges <br /> � Eristing anJ proposed utiGlies • Show measuremenls � <br /> DO NOT WRITE BELOW THIS IINE <br /> PERMIS CONDITIONS O <br /> 1.All c�Ils lor Ine.pectlon shall be made 2A hra.In edvence•phone 25�8810. � <br /> 2.All work ehall be perlormed in eccortlance with thla permit and cuvent Clry ol Everett Desipn and Conetructlon <br /> Standerds antl Specillcallona <br /> 3.Call Localion Underground Service 4B hra belore you dip.TOLL FREE NUMBER 1�800�424b53s. � <br /> �� Fi II 1►'IV�� I�L �"JI2jL� 'l�li vnBA/1l•J' $0 dL � Y10� iM(JALt <br /> s�r�d;n9 �ebrk�,,,5) pra�Ei es . Edcy� sloPes orF fl 11 O <br /> bhz�,U hp{. exce�d Z 'H : 1'�. � <br /> -�r, E'roJiOn c o��C�-o/ 51�1/ 6C i�rS'FT ll,td ds d`/Y��Cd � � //� <br /> l�ibl,� uJv,-�s �n�Yp�' O I <br /> �. /+s �ei'� �-��%d s��u�. a <br /> — <br /> ,�1 ACKNOWLEDGEMENT OP CONDITIONS <br /> � Si`Z'-.�-c ,SY�+n <br /> °�'�/'� ��1 _ _ _ Thounder�iqnedowneVapplicanthe�CbyagreeStOhWdanAsaveharm• <br /> 11 � � less ihe Cdy o1 Everetl Irom any and all cleims lor tlamages. cosls. <br /> --����/�� � evpenses. or causes ol aclion thal maY anse because ol inslallation <br /> �b� � anA mamtennnr.e n! Ihr imprOvement or olher nph1�01•way use hereto <br /> f� _ I �ppi�r,d 1 r anA urther a9rees to remova same upon notice Irom ihe <br /> Approved for n uc on ��� I Cdy an t rep ce p�b6c property damaged Ihereby. <br /> 8/p � �O -/ 9 f <br /> FIN L SPECTION Date / <br /> Approved as Constructed S�gna of Apphcan! Date <br /> PU9LIC WORKS DEPARTMENT H'ORK AUTHORIZED 0Y THIS PERMIT MUST BE STARTED WITNIN <br /> 3200CadarStreet �80 DAYS OF DATE FERMIT IS ISSUED ANO�THEREAFTER IS i0 <br /> Everet4 WA BB201 BE DILIGEN��Y PURSUED TO COMPLETION.THIS PERMIT MAV 8E <br /> Phone:259•8810 CANCEI.LED BY THE CITY UPON ANV STOPPAOE OF WOqK ON THIg <br /> PRO.IECT OVER 90 DAYS DURATION. � ' <br />