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„ . . <br />; \, <br /> oa�e J v�mK won.c��mn• —/OS <br /> AppllCetlon For 8�0p D�ot• 7 _ <br /> PUBLIC WORKS PERMIT °�°;o,;;��:F•• . <br />� L����OPI FN P�IU { <br /> IPrint or Type Only 8.�.�=.o�. •�� <br />� ����Inlis �� ��” �iO3/- 3J�S'G E�r+�77� (,J/� ���y 3s�- �o67 <br /> Owner Mellinp Addreee Clty Zip hone <br /> I �46wF <br /> ApPlicant Ma11in0 Addres6 City Zip Phone <br /> Deecribe Propoeed Work _. r � Q'��O< <br /> I <br />' W <br /> Pro)ect Addrese(II known) � 3� � Cb �� � <br /> Attach four(4)coplee oi plane lor propoaed work• Drew to scele and note the Iollowinp ea epplicable: � <br /> • Property Linee • Centerline ol street � <br /> • Outline end dlmeneione ol all ezletlnB end • Indicate North <br /> proposed structures on tho lot • Show any proposed grading chanpea <br /> • Exlstinp end propoeed utllltles • Show measurementa � <br /> DO NOT WRITE BELOW TH:S LI4E O <br /> PERMIT CONDITION$ <br /> t. All calle for Inapectlon shell be mede 24 hra in edvance-phone 259•8B1 5. � <br /> 2. All work ehell be perlormed In eccordence wlth this permit end current City of Eve�ett Deslpn and Conatruction <br /> Stendarde and Specllicetlone. <br /> 3. Cell Locatlon Underground Servlce 48 hrs.before you dlg.TOLL FREE NUMBER 1•8W424•5555. � <br /> fl TO BcF Cd�/si,C[:C'TFO j�� ,dPP,l�oNE;D �GdN� O <br /> l�.a TF,o � S'ic-.uC-lJ Y- /8-�s', <br /> � <br /> �� � <br /> �U�° 1� �` a <br /> � �� � <br /> �� <br /> � ACY,NOWLEDGEMENT OF CONDITIONS <br /> The undersigned owne�/epplicent he�eby apreee to hold and seve herm• <br /> lesa Ihe City ol Everett Irnm any and all clalms fo� damepe0. cost0. ��, <br /> expenses, or cauE�s ol ection thet mey arlae becauae of Inetsll.^.tlaa � <br /> � _ �� �J. and melntenence e Imp ment or olher rlphPol•wey uee'ieroto <br /> Appro lor Con uctlon^ ate applied n Aher egreea t remove eame u0on notice Irom the• <br /> Clry to lace public pro demeqed Ihereby. <br /> FINAL IN PECTION Date ����_ <br /> Approved ee Conetructed IBneture ol Applicant Dale <br /> everett PUBLIC WOfiKS DEPARTMENT WORK AUTHORIZED BV THIS PERMIT MUST BE STARTED WITHIN <br /> � 3200 Ceder Slreet 1B0 DAYS OF DATE PEHMIT IS ISSUED AND THEREAF?ER IS TO <br /> Everett WA 90201 BE DILIGENTLV PURSUED TO COMPLETION.THIS PERMIT MAV BE <br /> Phone' 259-BBt 5 CANCELLED BV THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />