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_ _ . �, <br /> _ .:, <br /> I,". <br /> i PUBLIC WO �R�K�, PERMIT D0t°�/��/%�q <br /> � � PUBLIC WQRKS DEPARTMENT Public Works Pertnit Y /G/.�� <br /> 320�edar Street �— <br /> Everett,WXD8201 259-8810 q�u O 4 �99�ullding Permit k <br /> � TOnP�STING ._---- 35.00 <br /> 1YPE OR PRINT ONLY ;_ ;r; �ri Publlc Works Fee$ <br /> =,; :� BB <br /> T;�+� � w� 6�:t �. � S � NU ��L s �v �� ���� p��,7. �j <br /> ,,,�, <br /> Owner Meiling Addreas�.. � "_ Cib Zip Phone Cf_ �� .� Z.� <br /> rn � a I <br /> �=, a � � I,�s. 3S 3 - �68 i <br /> O O i-+ w 7 C S <br /> � O (C :L <br /> 5 6 C'i I <br /> Applicent Malling Address City Zip Phone �I <br /> Describe Proposed Work Canst�vc 1� Srfe L'kzveLo r�c ��� �o� /'C, V Pnrk. � I <br /> � <br /> �//� <br /> t— � V♦ <br /> PROJECT ADDRESS(if known) � 2 J W � r��� � ' � <br /> Attech four(4)coples of plens for proposed work-Draw to scale and note the following it eppliceble: � <br /> I , ■Property Lines 'Outline and dimenslons of all ezisting and proposed structures on the Iot •Existing end proposed utilities O <br /> �Centerline of street •Indlcata North 5how any proposed grading changes •Show measurements � � <br /> DO NOT WRITE BELOW THIS LINE � � <br /> PERMIT CONDITIONS: <br /> 1.All calls for inspection shall be made 24 hours in advance- phone 259-8810. O <br /> 2.All work shall be performed in accordance with this permit and current City of Everett Design and <br /> Construction Standards and Specifications. <br /> . 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � <br /> � Gfia157-41` �/'/GC'cc.�? �n7�ianG� /�� C/7�� �// I . <br /> � ���7 � O <br /> Sfr+r,o�c rc/ a I <br /> ,� O[un�/- SLioIC B� �es/�o�,c,6Le �ar Correc ��� Gn� � <br /> I 4/'4rH95 C Pr"o6leh-,s T{n� h�4/ OCL!/r 7`�UM f�i;J � <br /> wor.F. T.Se Tr�'.C�,-o;f,o'h y.r�� ,o.,7�asCo� ��oe4rS I <br /> I �o GSG 4d���•4,�c 6oseo� oh -r�/� l.v�'or.r,q1`io.� �ro%c%�, � <br /> i � <br /> I la. .�i� sh�lC � �/ie 0!<J/lar' oF f/,e �?//_ /�ar.fJ � �e1Po.,c,�iL�fy '� <br /> ' fo Cao��:�4fc �hc vse o��/�c e4se�er�7/� a��css e�i�� \ <br /> � Thc Dcdher o� �� e••Seh-,�n-�ProPerf'y ( /nclu�n �'�i2 luQ�r�se�!�J <br /> �. LUOr o d��� 9--�-�� �'oPy9f,,��� ; <br /> I ,E f 6e er 4�pioved j�lai,s II <br /> ACKNCWLEDGEMENT OF CONDITIONS <br /> II � � �//� The undere!gned owner/appllcant hereby agrees to hold end save hartnless <br /> �/�/,%�./� A the Cky ot Everett trom eny and all claims for damages,coffis,expenses,or <br /> jr-r.� Qa'� causes of ectlon thet may eAse because of instelletlon and ma�ntonence of I <br /> �; Approv forConstruction e1e 1 thelmprovementorotherright-of-wayuseheretoappliedforandturtheragrees I <br /> �I 5.¢�,QQ.f-jmP, (6 be to remove seme upon notice from the Clty end to replace public property �, <br /> ; s�Cc�a�'r�oC�'''� dene c�iCC L•�-�- damaged thereby. <br /> � FINAL INBPECTION Date �� <br /> � � . .. ---- �7 . <br /> , Approved as Constructed q ,.r'--� -__, /,%�/5��6 '. <br /> ¢^ Z� �-/ ' �- ' ' � <br /> � rnature of Appllcent` . _ _ ___�i Date <br /> '� —_-_.._ i <br /> � WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMR IS ISSUED AND THEREAPTER IS TO BE DIUGENTLY PURSUED TO I <br /> COMPLEf10N.THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVEH 90 DAYS DURATION. <br />