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�8te"'r/�(� f.� �� ^ .. I FuEtle Worhn Permlt• _ <br /> Aoplicetion For �:ba.o.o�.. <br /> PUBLIC WORKS PERMIT 'NOTo�����F� s <br /> LW Mql h�P�M / <br /> BUMc�Ow � <br /> Print or Type Only <br /> Plen Chack Nos B 37058 SEPA <br /> Owner Appllcat.Datat 06[16/92 Phone <br /> Job A�nars3BOEIN6CCOMPANYD BLDO 45-242 <br /> Tanent� <br /> Applicant Propo�ed V��� CREW 6HELTER Phone <br /> Dasc. of Nork� <br /> CREN 6HELTER 1728 8F <br /> Describe ProDoeed Work _ OFFICE SET JOB SET � <br /> I�PPRVD FOR PEPMITt DATE_/_/_ BY <br /> _. W <br /> Pro�eet Addreas(il known) � <br /> Attaeh lour(4)coples of plene lor proposed work•Orew to eeale and note the lollowinp ae epplicable: � <br /> � Property Unes • Centedlne al etreet � ' <br /> � Outline end dimenelone o�ell exletlnp end • Indicate North ! <br /> propoaed at�ucWres on the lot � Show any propoeed predlnp chanpee ', <br /> � Ezistinp and propotnd ulllitlea • Show meaeu�emente M II <br /> DO NOT WRITE BELOW THIS IINE � I <br /> PERMIT CONDITIONS O � <br /> 7.All calls for Inspsctlon eholl be mede�I�re.in edvnnce•phone�6�8810. � <br /> 2.All work ehdl Da peAormad In eccordancs with thle permlt und curront Clty ol Everett Desipn and Conetrudlon <br /> St�nd�W�md SpacMlcdlona <br /> 3.Call Locatlon Undsrpround Senlce 48 hro.beloro you dip TOLL F11EE NUMlE111�800�4Z4�SBS6. � <br /> � � �° O <br /> P!/�c cvnzl�>y, J�'��,� � �� �e y{t� :.r�J <br /> � 0 <br /> �� � <br /> � �� ���� � N <br /> � <br />�� a <br />. � ACKNOWLED6EMENTOFCONDITION9 <br /> . The undersipned owner/applicent hereby aprees lo hold end eave h.�rm- <br /> leen the City ol Everett Irom any and all clalme lor damaqe0. coe10. <br /> expensce, or ceueen ol ectlan Ihat mey arlea becaune ol Inelalletlon <br /> end melntenenee ol Ihe Improvement or olher �Ipht•of•way use hereto <br /> epplied lor and lurther egreee to remove eeme upon notice Irom ihe <br /> Approved for Constructlon Dete City end to replece public property demaped thereby. <br /> FINAL IN'3PECTION Dale Dele <br /> App�oved en Constructed Signalure ol Applicant <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> � pUBLIC WORKS DEPAFTMENT 1B0 DAYS OF DATE PEFMIT IS ISSUED AND THEHEAFTER IS �TO <br /> 3200CederBt�aet BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Everell,WA 982Ct CANCELLED 8Y THE CITY UPON ANY STOPPAOE OF WORK ON THIS <br /> Phone:259-8810 PROJECT OVER 80 DAYS DURATION. <br />