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�B�B�jB' �unec Worxs Permn• 8 9-yG 8 <br /> Applicatlon For n�no oen� • — <br /> PUBLIC WORKS PERMIT �'����'cWorM�fee <br /> Totelfee s <br /> lma�oPi lee PeW s�_ <br /> Print orType Only e,�.�<.o�. s D� <br /> C d�•rt.t nN f��£✓�or�s <br /> i�EF'/'�iT <br /> ,��5. �o Srn L Ser d� c� ��L�Re«..o.+`► S7»i ta-h �J w-r P.Yi w P `i�r 2v 3-G 2-3 O <br /> Ownei Maihng AdAress City ZiP ph°�e 3sS �y�O <br /> S�„ E <br /> Applican� Maihng Address C�ty Lp Phonr. <br /> Deacriba f roposed Woik .T^/cS��lLL �F�rC/f $�JS,.✓ /��,tin/G- fJ,PE�q <br /> - W <br /> Pro�ec�Address GI knownl C�A'���"hNY P057 h_/��Ci,E _ � <br /> Atlach lour(4) copies ol plens for proposed work� Draw to scale and noto tho lollowing as applicable: � <br /> • Proper�y Lmns • Centr.dine oi s�reet /w <br /> •Outllne and Aimensions ol ell o�isting and • Indlcate North VP <br /> p�oposed slmctures on the lot • Show any proposed Jradin{7 changes <br /> • Existing und proposed ulililies • Sl�ow measuremF�'s � <br /> DO NOT WH17E BELOW THIS LINE <br /> PERMIT CONDITIONS O <br /> 1.All calls lor Inepeclion ahall be meda 24 hrs.In edvance-phone 259•887 0. � <br /> 2.All work shall be peAormed in eccordanca wlth this permil and r.unent City of Everelt Design end Constructlon <br /> Stenderds antl Speclficetlons. <br /> 3.Cell Locatlon Unde�ground Service 49 hrs.before you dig.TOLL FREE NUMBEq 1•800•424•5555. � <br /> _-----�_ <br /> , - • y�srAt G iVE�J C B 9No p��'� O <br /> " Ya Exisr��c, e8 ini PA�,en��r <br /> ;- "" - /).�e9. u5[ cn�vice.sre Pir� � ' <br /> �> �.e P-vc. ir- 3� nf rovE�C , <br /> � A vs'` ryP��� ce vF� � <br /> c,ry s.eNvA��o �` yo2 <br />� ��sf,�� jr�� b O <br /> �B �i , <br /> '�rf�� __ a <br /> O.0 <br /> CL.9.c'6ml�.�'T <br /> ACHNOWLEDG[M[NT Of CONDITIONS <br /> The untlersi�netl owner/applicant he�aby agrees lo hold antl save harm� <br /> less the City ol Everetl Irom any and oll claims lor damuges. cosls, <br /> expenses, a cnuses ol action Ihat may arise beceuse ol installallon <br /> .r�/ -, and maintenance ol ihe improvemenl or other nghl�of�wey usa herelo <br /> �"' ��" �`� �'� �9 appGed lor end lurlher agrees b remove same upon nohce Irom the <br /> Approvetl lor Construcl� n Dale Cily and to ePlace public operly Aamaged ihereby. <br /> �� �- �/7�a , <br /> FINAL INSPECTION Date � �� �^-��-f� � /� �'� d1 � <br /> Approved es Constructed Sainature ol Applicant ate <br /> everett PUBLIC WOfiKS DEPARTMENT WORK AUTHORIZED BV THIS PERMIT MUST B[ STARTED WITHIN <br /> � �200CedarSVee� 180 DAVS OF DAT[ P[RMIT IS 1SSUED AND THEREAFTEF IS T•:' <br /> Everetl.WA�J820t BE: DILIGENTLV PURSUFD TO COMPLETION THIS PERMIT M4V BE <br /> Phone�.259�8910 CANCELLED B�� THE CITV UPON ANV STOPPAGE OF WORK ON THIS <br /> PROJ[CT OVER 90 DAVS DURATION <br />