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� <br />�.,.,� no ociu7 nNl v <br />qpplication For <br />pUgLiC WORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA98P01 259-8810 <br />�0 POSTING ��N 1 R 't�96 <br />Date '3//y� � <br />Pu�:r: N'orks Permit 71 � O7 <br />Building Pertnit <br />Public Works Fee $ '�— <br />oLC,«f�d P ev:ourLy) <br />�� <br />�iN <br />Describe ProPosed Work u u v c <br />PROJECT ADDRESS (if known) <br />Attach four (4) coples of plans for proposed work - Draw to scale and note the fo�lowing ii applicable: <br />.pro�� �n� �putline and dimensions of .II existing and propose��s^ruc�thars eS the� I�o��toW m asurementsroPosed utilities <br />�Centerline of street •Indicate North Show any proposed c� 9 9 <br />..,. .�nr �n�c�TG aFl AVJ THIS LINE <br />PERMIT CONDITIONS: <br />1. All calls for inspection shall be made 24 hours in advance - phone 259-881 �• <br />2. 411 work shall be performed in accordance with this permit and current City of Everett Design and <br />Construction Standards and Specifications. ou dig. TOLL FREE NUMBER 1-800-424'S555' <br />3. Call Location Underground Service 48 hrs. before y <br />� Gv�,� �0 6� �on� <br />q����o� .3-� -96 <br />N.2� f-e�rse� �oL�r�� <br />���y a �� �.f� J <br />�� /,�� .3�/96 <br />ate <br />ppprov t onstruction <br />_�.- � �� <br />�' a�e <br />INA INSPECTION <br />qpproved as Constructed <br />� <br />O <br />V♦ <br />� <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undereigned ownedapplicant hereby agrees to holdc s�ts, ex hnseseor <br />the City ot Everett from any and all claims tor damages, P8 <br />causes of action that may arise beoause ot installaii�fora dturther�agrees <br />the improvemenl or other right-oi-way use hereto app' <br />to 2move same upon notice from the City and to replace public property <br />damaged thereby. � <br />� � <br />� J— <br />��� ta eD <br />��nature oi Appli ant ` <br />COMPLEf1�N RT�'�ES PERMIT MAY BE CANCEB EDTBY THE CINIUPON ANY 5T0 PAGE OF WORK OSN TF�IB�PR0.IEC OVER 90 DA SEDULRAnO Y PURSUED TO <br />