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_'P4;Y , '. .,, ' .,' . <br />'y, t. . .. � fr L4 l ( -' (fw a�� s <br />. d,' ! ..� �� . ,JG {�?! l,7"S�',y � <br />-.� . .. �'� ".a+2�iEVR.�L 1'�b�4lner. ... . . . _ . .�, . <br />_ av......_... <br />/ _ ... .,../'+" a �.I�c � . �__.._.'.'__'. ___. <br />� <br />Date J'0 B6 <br />, Applicetlon For <br />PUBLIC WQRKS PEFiMIT <br />Print or Type Only <br />Applicant <br />� <br />hddress <br />Address <br />Publlc Wo�ke Permll • <br />oiee. 000�. + _ <br />Pu�lic Worke Fao <br />Tolel Faa 5 <br />Lasf AppL Foe Peld w <br />Balonca Oua <br />4 ..J7:.J !JO <br />��io .2EC � �/l/7.S <br />Zip <br />Ciry Zip <br />�s�� - ys�.� <br />Phone <br />Describe Propo:ed Work _ �C{'9� ���'� Tp sT.�.�E P�POPE.C'T{/ <br />�'�.P.UE•C�S' S'oiG: -TES'T LYGG /�c/G �,: o.e 3 TEr: //oc�-_c ) <br />i <br />Project Address (if kncwn) � — <br />Attach four (4) copies ol plans lor proposed work • Oraw to scale and note ihe lallowing as applica6le: <br />o Property Lines • Centerline ol street <br />• Outline and dimonsions of ull exisling and • Indicate North <br />proposod slrucWres on the lot • Show any proposed grading chanye; <br />0 Existing and pr�posed ulilities � � Shovi measurements <br />PERMIT CONDITIONS <br />1. Atl calls lor inspection shall be made 24 hrs. in advance - phone 259•881 5. <br />2. All work shall be perlormed in accordance with Ihis permit and current Cily of Everetl Design and Construction <br />Standards and SpecNlcations <br />3. Cnll Location Underground Service 4B hra belore you dig. TOLL FREE NUMBER 1•800•424-5555. <br />f� L/mii s Of CCE.9�✓•r/G i9•d0 E�.eosio� CO.v7',�uG <br />J� G'ati�.e.y, ro /�,�,eovF-,o .��9•r�s_ <br />�;. . � <br />,. 5"' A.Uf/ AD,O/�ON�9G F�oSo�//S'Ed�/'nE.vi •�onl �'oN%�?c�G <br />,r : T/flli l�EC.GYnES A/ECc�'.,r.S'f�.e1/ S%l9GC ,�L�` IJOiLGF' i9S � <br />�,,�E-�rF.o .r�y 7`.�E c, y iLo�,c �,e,�,r T.✓sP�c,-o.e , � <br />`� ; ° �, A.C�EA ro B�- flyv,�vsFE-o� � w.TH.,�. - �� ��ys � <br />- y,�rE-e L�CE9�/yG. <br />% ST6EG ���-`� ON Ti+�E /1� W Co.P�E� G� Tic�E' �.eoPE.e7� <br />i(/OT 7D 6�' GYE/!�._.E`O � S'EE �9niJc'.YE'.O P�iT�✓S , <br />A <br />�;nProved as Consiructetl <br />everett PUSLIC WORKS DEPARTMENT <br />� 3200 Cedar Street <br />Everett, WA 98207 <br />Phone: 259•8815 <br />s/ � <br />Date <br />ACKN0IVLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicant hereby agrees to' oltl and save harm- <br />less the City of Everett from any and all clalms for damages, cost,, <br />expenses, or causes of action that may arise because of installation <br />and maintenance of the Improvement or other right•of•way use hereto <br />appiied for and further agrees to remove same upon notica Irom the <br />Cit` and/to reptace � blic property damaged thereby. <br />� <br />RK AUTHOR D 3Y THIS PERMIT MUST BE STARTED WITHIN <br />80 DAYS OF ATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WOFK ON THIS � <br />PROJECT OVER 90 DA'IS DURATION. <br />