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-- -- - -- <br />. , . - -- -- -- <br /> - --- - -- - ---__ _ _ - -- <br /> �a�@-� . . . ' r � � \\'/ . ':7.' � _� PuElit WorksPermil� � /�9 '_." <br /> ?Application For Biag.Dept• ��� U?y�3 <br /> i <br /> PUBLI_C�W'�RKS PERMIT Pu�TatelFeeFeB : <br /> Less AOPI.F¢e Paia S <br /> Print or Type Only Ba�a��oo�� s �rJ—" <br /> S?'<'d� T.P u t sad 9 Z ?O ��i,c/ i,.v Y T..�.T_t!E_LG `' �"n �� �/.�� )L z 9 <br /> Owner Mailing Address Ciry Zip Phone <br /> ✓I R"__�� • <br /> Applicanl Mailing Address City Lp Phone <br /> Describe Proposed Work ���s �- � <br /> Project Address lif known) �' Z� � �� <br /> Atlach four(4)copies of plans lor proposed work- Draw lo scale and note the lollowing as applicable: � <br /> • Property Lines • Centerline of street � <br /> • Outline and dimensions of all existing and • Indicate North <br /> proposed structures on the lot • Show any proposed grading changes <br /> • Exiating and proposed utilities • Show measurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS O <br /> 1.All cells for inspectiori shall be made 24 hrs.in advance•phone 259•8810. � <br /> 2.Ail work shall be peAorme!d in accordance with this permit and current City of Everett Design and Construction <br /> Standards and Specifications. <br /> 3.Call Lxation Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1-800-424•5555. � <br /> O <br /> � ' <br /> � <br /> O �' <br /> a � <br /> ACKNOWLEDGEMENT OF CONDITIONS I <br /> The undersigned owner/applican!hereby agrees to hold and save harm� <br /> less lhe Ci�y ot Everelt Irom any and all claims lor damages, cosis, <br /> expenses, or causes of action that may arise because of installation <br /> "�"�� n/l�� � /3 ``�, and mainlenance f the improvement or other righbol-way use hereto <br /> Approved forConstruction � �paie��� applied for anil rther agrees to remove same upon notice Irom the <br /> ,,: <br /> City and I�r� ace public pro erry damaged thereby. <br /> ! / <br /> FINAL INSPECTION pa�e % __ _ � <br /> Approved as Constructed � S at re of Applic at Date I <br />' everett PUBLICWORKSDEPARTMENT WORK AUThIORIZED 8Y THIS PERMIT MUST BE STARTED WI7HIN <br /> � 3200CedarStreet 180 DAYS OF DATE PERMI7 IS �SSUEO AND THEfiEAFTER IS TO <br /> Everett,WA98201 BE DILIGENTLY PUFSUED TO COMPLETION. THIS PERMIT MAY BE � <br /> Phone:259•8870 CANCELLED BY THE CITI'UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 OAYS DURATION. <br />