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a __ _ <br />� ; <br /> Date�� �u�nr 1Vnr4e Per �✓�o'''' �3� I <br /> qppLcalion Fo� mna o.n� • L L -���--+�—a.cd- <br /> RUBLIC WORKS PERMIT �y1Tot�fner�' s --_ <br /> i�s+enn� �oernn S `D� <br /> BMence Due S <br /> Print or Type Only I <br /> � � �-- ��. �� <br /> wner Madmg Address �iiy T.ip Phone <br /> q� Meiling Atltlress C�ry 2ip Phone <br /> Describe PrOposed Work ���d� �'�� J���I �� `�'�-�� , <br /> L <br /> ` __ <br /> - W <br /> Prolecl AAdrese(If knownl ?�G� — `-'�6�GG�� � <br /> A�IBch lour(4)copies of plens(or propoaed work� Oraw lo scale and note ihe IolloHinp as appllcable�. � <br /> • Property Lines • Centedme ot slreet � <br /> • Outline end dimansions ol ell eeisting and • Indicale North <br /> pro0osed structurxs on the lot • Show nny nwposed grading changes <br /> • Ecisting anu proposed utilitins • Show measu�emenls � <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITIONS <br /> 1.All cells lor Inepection sha�l be made 24 h�s.in edvance-phone 259•8810. � <br /> 2.All work shell be perlormed in eccordance with Ihis permit wnd current City ol Everelt Design and Conslructlon <br /> Stendartle and Specllicat�ona. <br /> 3.Cell Locallon Underground Service 4B hrs.be�ore you dig.TOLL FREE NUMBER 1•800•424•5555. � <br /> O I <br /> � , <br /> � <br /> O <br /> � <br /> � ACKNOWLEDGEMENT OF CONDITIONS <br /> n The unde�signed owner/appllcant hereby egroes to hold and save ha�m- <br /> -- - less Ihe City ol Everetl Irom any and all claims for demnges, costs. <br /> �: ��� /�/ expenses. or causes ol aclion Ihat may erise because ol installation <br /> O / e8 and mainlenance ol Ihe improvement or other nght�oi�wey use hereto <br /> �� O O -e��lied lor a�d Iwther ayrees to remove same upo� notice Irom ihe <br /> qpproved br Const� tion� � Date Cit and lo replace pubh property dame9ed thereby <br /> � / V � <br /> � <br /> ; � ; ,�.�� y�� _ , c � <br /> FINAL I SPECTION Date �' <br /> ApProvad as Constrvtled nature ol Appl e�e <br /> WbRI< AUTHORIZED BV THIS PERMIT MUST BE STARTED WITHIN <br /> rveretl PUBLICWORKSDEPARTMENT 180 DAVS OF DATF PERMIT IS ISSUEO AND THEREAFTER IS TO <br /> � 3200CetlerSireel 8E DILIGENTLY PURSUCD TO COMPLETION. THIS PERMIT MAV 8E <br /> Everetl,WA98201 CANCELLED BY TH[ CITV UPON ANV STOPPAGE OF WORK ON THIS <br /> Phone.259�8810 PI70JECT OVER 90 DAYS DURATION <br />