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���� <br />� 1 <br />� � ��te�7�1 <br />p' t � <br />A' ; ' <br />��.y <br />�� ; <br />�y T � <br />Y� ���M���' i <br />a <br />(� ;;q��� � <br />: f�:' <br />C�' <br />i <br />C�' <br />�: <br />,cr�� <br />�� I <br />� �. <br />� t0 POSTING � � L <br />�' APP��tlon for N <br />PUBLIC WORKS�ERMIT <br />Sg�Ng <br />Print or Typs Only � � � � � � <br />P <br />��e� g�� Box 55122 88att.�'e. NA 98: <br />g r� <br />o�M <br />— � - = T a <br />�4 t <br />� <br />I • <br />.,�"., .. , ' F" ,, . '.:';a•c"3%+� � ' . <br />` �'� <br />91 � , �,, , <br />PuDNc Wo�lu Prtmtl � � ^� 'v�t4 ., . <br />.�o�.�yr„�ls � <br />Pu01k WOIM� FN ' <br />To1N Fw y . . <br />Uu �VD� Fr PNO � nA� � . . <br />B�4r¢. ou. t �a� <br />Phone <br />� ' _ f -_ -_1 <br />, �J•�a •q <br />prpj�et Address (lf known) "'i <br />Ary�ch lour (4) coplee of plane for propwed work - Dnw to scale end note� CB°�,erline of atree�ble: <br />• Property Llns� � ��dicate Norlh <br />• OWlina �nd dimansbns of all existinq end � Show any Dropoeed pratling chanpes <br />proposed etructuros on the lot • Show measurements <br />� � Exletin9 �^d propoaed utHitlea <br />PERMIT CONDITION8 <br />1, M plls fa Impectlon ahatl be m�de 24 hn. In edvance - phone 259�8870. <br />Z�p ��p y� perlqmed �� accordance wHh this permit end curtent City of Everett Dasfqn end Construction <br />StenderM and Spedfice�lons. <br />3.G11 Loc�tbn Un�brpround ServMe 4e hra be�ore you di4 TOLL FREE NUMBER 1-80o-4245555. <br />4, Co�nec6 d��Jcwa��duwns��� c3.�c L'Loor dr2;hS �'Sar��v.✓'r <br />� 5. Ar.� roadw� � cv� 6 � 9�k.�✓ o� s:dcwy�� d�++-�a�A-d <br />stia�l be. �rcp��aced pw ei� s�dards ak p�612��K' <br />�A�G�.D`�S C,CKG�.�'\. <br />���, M� �X V ���( _ <br />� Approved for C elrudion Date <br />; ��_ G r- 9` _ <br />I FINAL INSPECTION Date <br />� qpproved as Constructed <br />i <br />' � PUBLICWORKSDEPARTMENT <br />S 3200 Ceder Sireet <br />Everett, WA 98201 <br />Phone: 259•8810 <br />r <br />�W <br />H <br />� <br />Z� <br />O � <br />� � <br />N� <br />e <br />� <br />O i <br />a <br />; <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/applicent hereby egrees to hold and save harm- � <br />less the City of Everett trom anY end all claims for Camages, costs, <br />expenses, or causes ot action that may arise because of instellation <br />and maintenance of the improvement or other right•of-wey use hera�o <br />applied for and turther agrees to removeed hereby.n �otice trom the <br />City and to replace public property <br />0 �-'t�"�9 <br />ign tura of Ap icant Date <br />WORK AUTHORIZED BY THIS PERM�T MUST BE STARTED WITHIN <br />1B0 DAYS OF DATE 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 WORK ON THIS <br />PROJECT OVER 90 DAYS DURATION. <br />