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� 1 3 20u1 <br /> PUBLIC ORICS PEFiNII� 2�19�97 � <br /> � PUBLIC RKS DEPARTMENT Publk WorW Perm%N �I � � <br /> 3 Cedar Strssl <br /> Evsretl, 88201 259•BB70 BulWinp PermR• 54259 '. <br /> � g 8 � 8 � g g S g Publk NbrW Fas S � <br /> TYPE OR PRINT ONLY ' ' �I <br /> :: ��� � � � � � � � i <br /> Y .eweNc RI � eRn _ <br /> Ownx :,ialllrp Atld � � � .r Zip Pharo <br /> ROG .R O .IN 3�2-76 � �5 ��� � ���� <br /> Applbant Malling Addreas City Zip Phonp <br /> Describe Proposed Work W U ■ � � <br /> W <br /> ~ <br /> � <br /> - -- � <br /> PROJECTADDRESS pf known) 5000 CHINOOK �R __ <br /> Attach lour p)eopbs o/plene for qopoaed wak-Draw to acale end note the followl�ip N epplicabb: � <br /> 'PropeAy Llnea 'Outline and dlmenslo��of ell exlatinp and proposed atrueturee on the bt 'F�latlnp and proposed utllltle� O <br /> 'CentMine W atreet •Indiceta North 5how any propoaed predlnp chenpea �Show meeauroments <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT C'JNDITIONS: � <br /> 1.All calls for Inspectlon shall be made 24 hours in advance-phone 259-8810. O <br /> 2.All work shall be peAormed in accordance with thls pertnit end current City of Everett Design end I <br /> Construction StandarcJs and Specificatlona. <br /> 3. Call location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-b766. � � <br /> . O <br /> a <br /> � <br /> ACKNOWLEDOEMENT OF CONDITIONS <br /> Zy Tha undxelpned owns�/epplicent harsby pisu to hold end uw harmisp <br /> / 9 7 tM Clty of EveiMl han eny end all clelm�for damepss,coeb,�Kpsnssa,a <br /> ved fa Const n Date cauaes W actlon thet may erlea becaues W InNsllatbn�nd mYntanerws ol <br /> 1M knproverrient or Wher ri�Fof•wey uas M�elo epplled faand hMher�s <br /> � to�emova wns upon nWice han IM CMy�nd to rapl�cs pubNe piopwty <br /> O—/1-f� dameped thsreby. <br /> FI INSPECTION Dats <br /> Appro•red ae Conatructed �n n� � O � 7'/ _ / ^ <br /> �C � <br /> nature ol AppMant p�te <br /> WORK AUTHORIZED BY THIS PERMR MUST BE STAHfED WITHIN 180 DAY9 OF DATE PERMR IS ISSUED AND THEREAFTER IS TO BE ql I(iENTLy pUpBUE,� ,rp <br /> CAMPLETION.THIS PERMIT MAY 3C CIWCELLED BY THE CI7Y UPON ANY BTt�IMOE OF WORK ON THIS PRpJECT OVEp pp pAYB DUMTION. <br />