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------, - <br /> �?��'' � +�� ;,. �-�?�'�r� :�-,+ �r:'�:-•�s�-c� <br /> �8te� � �\' PubGc Worka Perm11• <br /> ApplicationFor BIEQ.Dapl.s 90/25279 <br /> PUBLIC 11yORKS PERMIT P����=W,�aFee <br /> Totel Fee S <br /> less ApPI.Pee PaiO S <br /> Print orType Ur�ly BalanceDue s <br /> 1Cy1� 'richnologie� 10701 Swrqr�sn Nay Everett #D <br /> Owner MaiFing Atldress City Zip Phone <br /> rawad� Oe�rc;.al Oor►tr�oton 18915 - 142nd Ave t� A170 wooainviii• 98072 <br /> Applicent Meiling Address City Zip Phone <br /> Describe Proposed Work ��t ���t <br /> Project Address�if known� 10701 BV�! Ylaci Na — 8D � <br /> Attech four(4)copies of plans lor p�oposed work• Draw to scale and note the following as applicable: �� <br /> • PropeAy Lines • Centerline of street � <br /> • Outline and dimensions of all existing and • Indicate North <br /> proposed structures on the lot • Show any proposed grading changes <br /> � Existing and proposed utilHies � Show measurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS O <br /> 7.AI�ca�is tor�nspection she��be madu 2a hrs.in advance-phane 259-5810. � <br /> 2.All work ahell be performed in accordance with lhis permit and current City of Everett Design and Construclion <br /> Standards and Specitications. <br /> 3.Call locatlon Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 7-800�4245555. � <br /> � <br /> lJ�<—C CC�GZ/"�-� ��'/�•^t<{ �l�0 7` �lp�.Ltlh� O <br /> ����� � <br /> � 8 - �o <br /> � <br /> � <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> 7he undersigned owner/applicaM hereby agrees to hold and save harm- <br /> less ihe City of Everett from any and all claims for damages, costs, <br /> expenses, or causP�of action that may arise because of installation <br /> and maintenance o�lthe improvement or other right•of-way use hereto <br /> applied for and further agrees to remove same upon notice irom the <br /> Approved fo�Construction Date �ity and to replace public property damaged thereby, <br /> FINAL INSPECTION Date <br /> Approved as Constructed �'r; Signature of Applicant Date <br /> everett PU�LIC WORKSDEPAR7MENT WORK AUTHORI2ED BY THIS PERMIT MUST BE STARTED WITHIN <br /> � 3200CedarStreet 780 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everet WA 98203 BE DILIGENTLV PURSUED TO COMPLETION.THIS PERMIT MAY BE � ' <br /> �' "" � " CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259-881¢(r � � k- r��1 .' �= pROJECT OVER 90 DAYS DURATION. <br />