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TYPE OR PRINT ONLY <br />„�,� <br />PUBLIC WORKS PERMIT <br />ausuc vro�us oeanArM�r <br />:+Zoo csae� susst <br />EvereC, WA 98201 259-8810 <br />�10 I J�192q EvG�PI�°.r► Ur'�� <br />5i- 4(077 <br />., .. . ,,� . .: .. ... .. . . .. . <br />� <br />a� 4 /ZCo/�!o <br />waa waw �rr�n • "l lP,�� �P � <br />Bulldiny PertnR M <br />a�a�c w�s �e S — <br />C!ri <br />qpplicant Malling Address �nY vP �O^a � <br />._ - ...:_. . <br />PROJECT ADDRESS (ff known) <br />�I <br />�'ii qq41 ��IZ'; �r�raevt <br />a�ad, ta,r �a) coples m a�+$ � woa� wax - orew �o ace�e and note me ro�ww�n9 n epWkawe: <br />�propMy Lines �Outllne and dimensbns of all e�stlng and proposed stnictures on the bt 'Existirre and propoxd WIHba <br />'Centerline of strest 'Indkate North 'Show erry proposed Weding chanyes 5how measurements <br />PERMIT CONDITIONS: <br />1. All calls for inspectic� shall be made 24 hours in advance - phone 259-8810. <br />2. All work shall be perfortned in accordance with this permit and cunent City of Everett Design and <br />Construction Standards and Specifications. <br />3. Cali Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-d666. <br />4, tYl��l box ba�e mus� !� 5� h��K a min�mumo�F 1�'oot <br />�ian� ►�k ed� a� s�dewalk. <br />5. Obk,��►n app,o� 1 of Pos� o� ce p�r�or -�o �onstru�t�on <br />p-� m2�il I�x �'i5e. Cov1-�tlr� EZoVI 5Gf?.���ni c�i-�1G �/C�. <br />laMf, 81?,0 (�rd�5oh l�� <br />nGwow�Eoo�Errr oF coHomor�s <br />�� ��� 7ne u�dersqned ownedraWkaM hxWy epnss M hdd rid aaw n.enMs. <br />the CHy of Everott hom any and eN cl�ims fa d�mepK� casls� e�uss� or <br />Approved fa Constniction Date ceuaee M actbn that mey arbs becwe� d MqalNlo� and mWitanrics d <br />ths knprovemant adhw rlpMof-way ws MMo�pplf W faand futl�er qew <br />���� `� � �� to rwnovs same notk:s han ttN CKy and b nplece W6Nc P�PMY <br />/ /Y�la/'L� .Z �'2 (o` �(�, <br />Date �� �a �. �� i �tC B�• �rr"7 <br />FlNAL INSPECTON �-� 1/ <br />nppored as ca,atruceed � t/�.�.�_ ��L/ S�i � 96 <br />�"°�' /�R7il/��� L� O� D�a <br />WORK AUTFIORIZED BY iHIS PERMR MUST BE STAFi'TED WITHIN 180 DAYS OF DA7E PEWdff IS ISSIIED AND 7}�AFfBi IS 70 BE D�JO�n� �11�070 <br />CpAApLEf1pN. THIS PERMR MAY BE CANCELLED BY TF� GTV UPON ANY BTOPPA(iE OF MiqiK ON 1HI8 PROJECT 04ER 90 DM'S OlNiA710N. <br />