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�..�. — <br /> j�-2� S <br /> 6 27-94 / '� <br /> Dete_- iJJtL� 2f•O <br /> 0 POSTING �,.,, , ,.,�,.,o..m„. -- <br /> APPIir,aM1on For � � H�n� o.r� . ._/j(J](�___.__ <br /> PUBLIC WORKS PE�MIT sEP" `Z-94 _—_— <br /> �„�.,,�W�."�.� <br /> � ,�,.,��.. : <br /> �.,,.��„ �...�:,-, s <br /> Print or Type OnIY � $ Q $ g � � � r.,�.,,. .,o.,_ s/�-�— <br /> � � p � M � r� <br /> N ..Mi M <br /> Earl D Beegle 5007 Clazemont Way �e � t W � 9 3 258-7050 <br /> OWnPI Ma�iir.. .lndr(�Ss — <br /> � � � � i it' Phnnc <br /> Contac[: Owner 6 James Thomas (Imp�se � � ���g�� <br /> APPlicant Pl�Iin:IAdtln�ss —�___—_'�it; .__.__—Z'�_____ ________--_ —.___ . <br /> P9�m•, <br /> oescrme P�opos�d work __rebuild medical clinic <br /> - - - -- - <br /> ---- <br /> s-�oz_ _ __ - -- - - - - - ---- — W <br /> a�oiect naaress n�koowal _��R__ C L4ro.[non�F__ _',' � <br /> Afleeh lour 141 coUies ol Plnns lo� PmPoseJ wu•. - �rnv lo .r,f,.. .u•.a nclr�Q��r.winy a::anUhnhh------_ <br /> � Pronerty Lmes � <br /> • Cenimlmn nl ghe.•� � <br /> � OutLne antl Aimersions ol an e.istmg ann • I�mcate North <br /> proposed SIruCWreS on Oie lol • Shnw any r.roposptl gratlmq r.hanqrs <br /> • EMisling and proposed ulilities • Shnw mn�su�emenls <br /> �. DU NOT WRI7�E BELOW fH15 LINE � <br /> • PEFMIT CONOITIONS � <br /> � 1.All calls for innpaclion ehall be meda 24 hrs,in edvance•phone 259•8870. <br /> � 2.All work ahell be pedamed In ecco�dance with Ihis pe�mit end current City ol Everett Design end Construction ' � <br /> Stenderde end Specilicatlor a. <br /> ! 3.Call Location Underground Service 48 h�s.belore you dig.TOLL FREE NUMBER 1•800�424-5555. <br /> r ¢ �f/A-,� -�o � <br /> 6e O�onc �cr �l¢hs � �Pro%� O <br /> 4h 9��95�- by f/,c E✓crz�/ PuGl�c h/Or�"s <br /> �c1°y a�4 c%� � <br /> i /� <br />� V/ <br /> O <br />� <br /> a <br /> I �� ACKNOIh'LEOGCMENTOFCONDITIONS <br /> ____ ____. .-- ih�,unders�qn�downei�aPPhcantherebya9reestoholdandsa��eharm� <br />. � �i irss Ih.� City ol Fv�relt hom any and all claims for tlamage5, costs <br />' ; e.prn,e; m wuses OI FIGIOfI Illd� RI:{Y Tf15^ hecause ot m;tallafion <br /> p ind mamlPn�nr.e ni th� impwvemenl or niher n�ht�of�way use h.+rr!10 <br />� Approved lor Co ru on --� s -�- � ��r.n��nrf 10� and hutho� nqrees lo �emove same upon nohce hom Ihe <br /> f -- <br />. , �� �t�� i G'v md In n�pl,�ce pubhc proppity d0maged therCby. <br /> �'"���-�i�c�.. /J /r 5y � --=/IQ� '/^/ � <br /> FINAL INSPECTION � —JE dl � C <br /> Approvod as Constructod I Signatwe An I�r.an! � D�t� <br /> � PUBLICWORKSDEPARTMENT I WORK AUTHORIZFD BY THIS PERMIT MUST BE STARTED WIiHIN <br /> 3200CedarSlreot I �90 DAVS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everelt,WA fl8201 BE DILIGENTLY FURSUED TO COMPLETION. THIS PERMIT MAV BE <br /> Phone::59-BB10 � CANCELLED BY THE CITV UPON ANV STOPPAGE OF WORK ON THIS <br /> i PFOJECT OVER 90 DAVS DURATION. <br />