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✓�� /� �] i� ' J j <br /> Datell���� / ��.,�.�,w�..,��..,�,�. - " — <br /> Applir.alion For t+�an Den� • <br /> PUBLIC WORKS PERMIT °°°���W°."°°°----- <br /> ,��.��.. s-- -- � <br /> ��•.i em�� vn.rx�a S � <br /> Prir�t or Type Only ,+„r�„n�� S •j✓c'_r _—- <br /> � � � �-rx�r `'�.vl� _ .�r�.33 C'LA�=n'Ya►'t� i.�A�l_ �l� <br /> w <br /> pW�e� Madmg AAdress GtY Z�p Phone. <br /> W��IicBnilJi.1�U//w�'//Q�Vailipp AddrC�CS�Q.y W,�� ,il �� �TWZ.r� /f�� <br /> N �;i /� �s <br /> Deacrib Proposed Work � " �r "D'v _ <br /> � �1 L � 1 °11��•�t-JD�-- <br /> --- - = W <br /> Prolecl Addrecs lil knownl �r J�-� �J ��luU/5��1��--� � <br /> Attnch lour 14)topies o� p�ens lor proposr.d work- Draw to sc�le antl note�hr lollowmn Ids apPhcable. � <br /> • Property Linus • Genterline ol street � <br /> • Outhne end dimensions ol ell e.isling and • Indmale North <br /> proposed structures on the lol • Show xny proposed prntling chenges <br /> • Ezisfing and proposed utilrties • Show measurements � <br /> DO NOT WRITE BELOW THIS LINE O <br /> PERMITCONDITIONS <br /> 1.All calls for Inspecllon ahall be made 24 hrs.in advanca�phone 259•8810. � <br /> 2.All work shall be peAormed In eccordence wlth this permit end current City of Everett Design and Constructlon <br /> Stendards end Specllicationa. <br /> 3.Cell Locetion Underground Service 4B hra.balore you dig.TOIL FREE NUMBER 1-800-424•5555. � <br /> �S �� �/ � / O <br /> l,Ct�� <ti�,r,�� �t� � l7�i-7-(.., �rt/. _ /.`/�f Ji+7 .�,�.. <br /> • J / / <br /> y���- � �/(J.l��r� �— • ^S' —.1���, <br /> OS/22/89 11:40RM OOOA115912 ;1�; <br /> / � <br /> q00020976 O <br /> D�iVNI 435.00 <br /> CHEG; 535.� � <br /> ACKNOWLEDG[MENT OF CONDITIONS <br /> 7he untlersiyned owneUapPhcanl hereUy aqrees lo hold and save harm- <br /> —i �ess Ihe Gty ol Eveielt from any and all claims lor damages, costs. <br /> / eMpenses. or causes ol action that may anse because of installption <br /> ,-"J��, �J: . � � � � anA mamtenante ol Ihe imprpvement or r nght�obwBy use heir.to <br /> �appl�eA lor an � er agrees lo rem e ame upon nolice Irom Ihe <br /> Approvetl lor Consiruc � n / ale Gly an repl� pu c pio Y tl tl Ihe y. <br /> / /��-. <br /> ��� ��� "�L- l �t /l' � SY <br /> FINAL INSPECTION Z � Unt�' <br /> Appioved as Consirucled Signalwe ol Apnhcant Da e <br /> everett PUBLICWORKSDEF'ARTMENT WORN AUTliORIZED BV THIS PERMIi MUST BE STARTED WITHIN <br /> iB� DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> � 3200 Cede�Slreet BE f�ILIGENTLV PURSUED TO COMPLETION. THIS PERMIT MAV BE <br /> EveretL WA 99201 CANCELLED BV THE CITV UPON ANV STOPPAGE OF WORK ON THIS <br /> Phone�.259�BB10 PROJLCT OV[R 90 f1A'�S DURATION <br />