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M pA <br /> �e�e��91 u Q D - �°° P„h��Wo,,.��,m,�. 9/- /3s _ <br /> A�aa ��ol . _ <br /> y ADP��cation For <br /> PU�IC WORKS PERMIT P������Worx�Fee s <br /> folel Fee <br /> � le�� >i Fee Ve�e s_ <br /> � O B�iencaD�e s �v� <br /> Print or Type Only� �� <br /> 0 o �a d02-32Z- S�O-�oO- /.3 'd9� <br /> � N <br /> P/yl ESTEP N /�/ (�uCKER s��E �l/El�� 98.Zo/ 252- 'F9�8 <br /> Owner P �` �� � Mailing Atldress City 2�p Phone <br /> � <br /> � � U _ <br /> qpplicant MaJing Address Gty Zip Phone <br /> Deacribe Proposed Work C.�E/�f� TREE S7L(A�t PS � �L/t/`�E� � .E�Ae K BERR/�s' mA.� <br /> srT� .�vv .��E'Y w.a y <br /> I', /� W <br /> Project Address pl known) � " E ERE W �/! � <br /> Altach lour(4)copies of plena lor praposed work•Draw to scele and nota the lollowing as epplicable: � <br /> • P�operty Linea • Centerline ot streel � <br /> • Outline and dlmenaions ol all exiating end • Indicele Norlh <br /> proposed struCtures on the lot • Show eny proposed grading chanpes <br /> • Existlnp end propoaed utllitiea • Show meesuremenls M <br /> W <br /> DO NOT WFITE BELOW THIS LINE O <br /> PEFlMIT CONDITIONS <br /> 1.All calls lor Inapecifon ehall be mede 24 hre.in advenr,e-phone 259•8870. � <br /> 2.All work ehell be peAormed In eccordence with ihls�ermll and current City ol Everett Deeign end Conatruction <br /> Slendarda end Speclllcetlona. <br /> 3.Cell Locetion Underpround Service 48 hre.belore you dip.TOLL FREE NUMBER 1•800�424•5555. � <br /> �i�. �.¢�� S�.e.fa� �t a�.. a.� �e.ei .��s.e.a- O <br /> .S 12oGuON !1J'2.o'�0+^' (�,,,��I'L .�Go�r•i-^�[a�.[e�"' � <br /> C�r.�-P �d.�.� t� �e, y� w�- V� <br /> ���.�. � � <br /> a <br /> ACKNOWLE�GEMENT OF CONDI110NS <br /> Tho undersianed owneqepplicenl�ere6y agrees to iwld and save harm- <br /> O less the City ol Evere�l Irom any and all claims lo� d&maBes. cosis. <br /> C-'��/ O _ `/� ezpenses. or causes ol action thel maY erise hecauve of ins�nllatlon <br /> �� j� �/ /�_�/ end maintenance of Ihe improvement or other righFobwny use narelo <br /> rvvc, T applied lor end lurther egrees to remove same upon notice hom ;hn <br /> Approved for o Irucll n � �e�e Ci�y and lo replace public property dameged thereby. <br /> a,.�- � �-/Y-5/ � I,�A <br /> FINAL INSPECTION ^ " � ` l� �/ q/ <br /> Approved es Conslructed Date Signature of pGcant Dar te <br /> � PUBLIC WORKSDEPARTMENT WORK AUTH RIZED BV THIS PERMIT MUST BE STARTE� WITHIN <br /> 180 DAYS OF DATE PERMI7 IS ISSUED HND THEREAFTER IS TO <br /> 3200CaderStreet BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> Everett,WA 88201 GANCELLED BY THE CITY UPON ANV STOPPAGE OF WORK ON THIS <br /> Phone:259�8810 pqOJECT OVER 90 DAVS DURATION. <br />