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IUEIrc Work�Pumll• <br /> Date� Bwa o.p� . 36584 <br /> Appllcetlon For <br /> PUBLIC WORKS PERMIT `°"'�""°""" <br /> 7ot�l Faa � <br /> Le��A00�Fo G�iO f <br /> g�bnc�Du� { <br /> Print or Type Only <br /> gpeing Co. PO Box 3707 8 0 -76 Z�P Phone <br /> Owner Meiling Addresa ���1' . <br /> Ovmer <br /> Applltanl <br /> MeilfnB Addreea CIIY Zip Phone <br /> De6crlbe Proposed Work <br /> - M f flA � 1 e D�{w1/��s w�J..� ����� <br /> W <br /> Pro�ect Addreee(N known) � <br /> � <br /> Attech lour(4)copies of Plens for proposed work• �rew lo ecele and nole lhe Iollowing es eppliceble: � <br /> � propeAy Lines • Cenlerline ol atraet <br /> • Indicate NoAh <br /> •Outline end dlmeneione of all ezfetlnp and � Show enY Propo6ed giedinB chanpea <br /> proposed slructures on Ihe lot � Show meaeuremanta M <br /> • EKistinp and proposed utilltles W <br /> O <br /> PERMIT CONDITIONS � <br /> 1.All alla lor In�pectlon ehNl be mede 24 hra In advencs•phone 2bY�10. <br /> p.All work shdl bs psAomied��ecead�^�°wUh thls permit and cunent Clty ol Everott Desipn end ConMrudlon <br /> 8UnMrd��nd 9pscNlcatio�a � <br /> 3.GII Loctlion Underpround SSMca 48 hra belore you dip.TOLL F11�L NUM�E117-000�4R4'6666• <br /> O <br /> ,�� d�,�..� �� �- ��- ��y � <br /> ��r�� <br /> �'B Z V� <br /> � <br /> ACKNOWLED6EMENT OF CONDITIONS <br /> less theBCitynol�Evarettepom�any e d ell cealme�lo�'da epe4 co�a <br /> expenses, or causes ol ectlon thet meY arlse because of Inetelletion <br /> end mainlenance of the improvement or olher ripht•ot•way use hereto <br /> epplied lor end luriher aBreee to remove seme upon notice Irom the <br /> Approved lor Consiruclion Date City and 10 replace public property damaped thereby. <br /> FINAL INSPECTION Dete Dete <br /> Signature ol Applicant <br /> ppproved ae Constructed WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> � PUBLICWORKBDEPARTMENT 1B0 DAVS OF DATE PEHMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200 Cedar Strset BE DIUGENTIY PURSUED TO COMPLETION.THIS PERMIT MAY BE �� <br /> EverotL WA 98201 pROJEC7 OVER 90 DA S DUR T ON.STOPPAOE OF WORK ON THIS <br /> Phone:269�8810 <br />