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� PUBLIC WORKS PERMIT �° �—?���°LR� ' _ <br /> `c��� ��,��� ���. o <br /> 3200 Ceder Stree� —C�� <br /> Eve�Ml.WA 98201 25&8810 g������ <br /> TYPE OR PRINT ONLV PubNc Works Fae S � � <br /> o� n�www a�a� ��r � P11O"'G i►u�C.r Knox <br /> .ri �'2 M H I LL. 777 - �o�-�+ 15.v� �t��ti�^r� wfA t-42s�s3-socb -- <br /> Applicant Meiling Address �Y $ <br /> Describe Propc.sed Work ' vSki �Orl W <br /> � <br /> �� <br /> .— Z`�orLTe/M�Mr�/Q,�--- V� <br /> � �,�n a I � F�u�;� �•�K. <br /> PRO,:�.CT ADDRESS(f k�own) � � /� <br /> Attacr four(4)copbs of plans for proposed work-Drew to scale and note the fdbwkq H applicable: ' �� <br /> 7roperty lJnes �OWllne and dHnensbnn of ell existing e�M proposed atructures on the bl 'Fxktkq end propoaed utYitles � <br /> �Centerline ot streel Mndicate North 5how anY P���9�Iny chengee 'Shrw+meeeu'ea�enb � <br /> DO IJOT WRITE BLLOW THIS LINE � <br /> PERMIT CONDfT,ONS: <br /> 1.All calls for inspection shall be made 24 hours in advance-ptrone 259-8810. O <br /> 2.All work shall be pertormed in accordance with this permit and current City of Everett Design ar�d <br /> Construction Standards and Speciflcations. � <br /> 3.Call LxaCron Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-6666. H <br /> �� l ��,rNAN'�'. �!�!i{1 �1'1� rJ�l1A l� � � (�i��,/�' � <br /> 1 O <br /> d�1�u�dird P�z� �3�� a <br /> 5, U.se �P�rD�r�r��E�Z 5�-� �st�9h zc� frnd ��ic��pr� - <br /> i):-v�-5'> . .3o'r'-; <br /> u ys"��� <br /> o1r-..; �o.co <br /> �OT�1: °G.G(i <br /> �_.i-=�:=i! =0.��(? <br /> .. {;iii-.-,-. <br /> ACKNONM1EDGEMENT OF CONDRIONS <br /> � (Z !�o q� The���o,�����t��,to��,.�� <br /> tne Cky of Everetl hom any end aY clalms fa demapu.coatn.expeme�,a <br /> ved for stru� tion ate ��of�����3°�8 ot hmtelNbn end meintenerwe d <br /> APP the improvernent o:other rlgMof-wey use heieto appied fa end(urthx BP�s <br /> to rertave seme upon ratice hom the Cily and to repk�ce pudic properly <br /> _G�v�"��� dameged t <br /> FIN INSPECTION Date <br /> Approved as ConsWcted <br /> � nahi f ApplicaM Dab <br /> WORK AUTHORIZFD 8Y THIS PERMIT MUST BE STARTED WfTHIN 180 DAYS OF DATE IS IaSI�D AND THEREAFTER IS TO BE DIlIOENTLY FUHSUED TO <br /> COMPLEfION.THIS PERMR MAY BE CANCELLED BY THE CITY UPON ANY STOPPA(iE OF WORK ON THIS PROJECT OVER 90 DAYS WRAiION• � <br />