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� <br /> r <br /> Det6sL.�� v„eiK wan.v.�mu. g¢ <br /> AppllceNon Fo� eieo Dm�.• ✓r <br /> PUBLIC WORKS PERMIT///////////�--//�77 � � °�°;;,,;:F•� : �ti� <br /> / /� � 1...eoo�.F.•v.m t _ <br /> Print or Type Only <br /> �/ ��7 a.�.��.o�. .�— ! <br /> �,A�es �-�(n,Jc�o �ln 0�0 `/��/4''�lJ�s % E�7' 7 c��0`� l33 3 -G, /,s� <br /> owTer Meilinp Addresa Ciry 21p Phone <br /> V /i1nP1 <br /> Applicenl Mellinp AtlOrese City Zip Phone <br /> Daecrlbe Propoaed Work �.�.� s�2�� / i-�ci��6 �r <br /> W <br /> Prolect Addreee(il known' � <br /> Allech lour(4)coD�ea of plene for proposed work• Drew to acele and note Ihe following as epplicablc. � <br /> • Property Linee • Centerline o�street � <br /> • Outline end d�mensionn of ell exletinp end • Indiceta North <br /> propoeed etructures on Ihe lot • Show Bny proposed gradinp chenpea <br /> • E�letlnp end proposed utlllllee • Show meesuremenls � <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> t. All calle for inepectlon ehall ba mede 24 hrs. in advence• phone 259•B81 5. � <br /> 2. All wo�k ehell be pertormed In eccordance wiM Ihis permil and cunent City ol Eve�ett Design end Construclion <br /> Stendarde and 3peclllcalions <br /> 3. Call Locatlon Unde�Oround Service 48 hrs. belore you dig.TOLL FREE NUMBER 1•800•424•5555. � <br /> .�. p_o-r /��rs �j��r�� G -/� -9g O <br /> / �' <br /> � <br /> � <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applleant hereby e0r9ea to hold entl save harm� <br /> / less iha City ol Everett Irom� ny and ell clalms lor demepes, cosls, <br /> �� eKpenses, or ceuses ol eclio t may arisa b cause ol inelallellon <br /> � and ainlenence ol the impm em�n�or other �i ht�o��way u6e heiato <br /> applie lor and lurthe� egree! o remav8 ea upon notice Irom Ihe <br /> A rova ot o ction Dele Ciry e lo raplecn pub!ic prope ty deme fh by. <br /> �_�� l���p. �u-F� �, �� � <br /> w "� <br /> '- FINAL INSPECTION Dete <br /> ApprovedAeConslruc�ed SlpnaWre Applicenl Date <br /> everett PUBLIC WORKS DEPARTMENT WORK AU HORIZED BV 11115 PERMIT MUST BE STARTED WITHIN <br /> � 3200 Cedar St�eel 180 DAV OF pATE PERMIT IS ISSUEO AND THEREAF7ER IS TO <br /> Everett, WA 90201 E DIL NTLV PURSUED TO COAIPLETION. TViIS PERMIT MAV BE <br /> Phone: 25B-BB15 CA ELLED BY THE GTY UPON ANY STOPPAGE OF WORK ON THIS <br /> PFOJECT OVER 50 DAVS DURA7IUN. <br /> L " <br /> L ' <br />