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— <br /> oate� / . / 233 - — <br /> �_/� Pu01ic Warka Permil• � <br /> Applicetion For eiae oea�.•_ <br /> PUBLIC WORKS PERMIT P�b,o,aFao�eB s <br /> TO POSTING._� � y ��"Aoo�FeoPaia : ao <br /> Print or Type Only aanceDue S 3S— •i� <br /> / / :�b2-3zz-¢n - ono�/% 8�/ ;� <br /> i Grfi� E �I�J�� �b� �.. A�r��Z� �'�r �1�37 7�F3-41� <br /> 7wner Mai{;ng Address City Zip Phone <br /> l _C'S C6h, s � Lo � !4GlS Su�vsc,� R� �e7T� ��G 44 9d'QlZ �-��� <br /> Apphcant Mailing Address City Zip hone <br /> � / � <br /> Descri6e Proposed Work �N S� �. i A![ �EW �r�6-�A/A-�c�f�yy�,.r_e � lfrJ�/ �'y,� � <br /> 6� <br /> DO �." – .r C..e v� ' Q� ! <br /> � ( Q /� ` 1 � I <br /> Prolect Address�it known) ���� (70 £V.Ly.L , 4.t�..� � � <br /> Attach(our(4) copies oi p�ans for proposed work- Draw to sca�e and note the lollowing as applicable: � <br /> • Property Lines � Centerline of street � <br /> • Oulline and dimensions ol all existing and • Indicatc North <br /> proposed structures on the lot • Show any proposed grading changes <br /> • ERisting and proposed utilities � Show measurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS O <br /> i.All calls for inspection shall be made 24 hrs.in advance-phone 259•8810. � <br /> 2.All work shel!be performed in accordance wiih this permit and currer,t City of Everett Design and Construction <br /> Standards and Specificetions. <br /> 3.Call Locetion Undergrountl Service 48 hrs.before you dig.TOLL FREE NUMHER 1-800�424-5555. � <br /> / . `.4l`C'/✓ F'llci�-..� ')9tC�y7� UK- �_' i(![`� �,../ C!'�lj2,!'_�� <br /> sF�..�a-,.��tf 5%� �� ��:..,.< <-..�(�n.����.,,, ,s��:.�Q,lA�MynS o <br /> 5' 7"/�, P��.�-z� �a.������.wf.�a,il' h�,a`� ' � <br /> � -�,�,, <br /> ��'�-f--c-�'`��I, a�.�/w .�ca� �dz,ec�,t, , <br /> (/ .� /��u-Ti {��,., . <br /> UJ, �C'P�- ��ee7`� `��i'1G,-i, �� 2,l'-�''_ .�,t�,,.�,�i V <br /> 7. /�/JOL�I� c"z.��f 7zc�irin.Zy( ✓c,'�2.�-GC, !'t��r� O'.� S�/SrSf � <br /> � r/ 6 c <br /> 8 �p�,1.��r.:..�* -c.� . /Le�/��am•-c.�.GCc, �/-�`' c��-�7`n-�T�L�a <br /> � �.�..�.�h� r/�li.�•7� /1<</�Gs� .� ,Grl eeC��LLvS.��/v/� < <br /> 4�� �% �2�c( � 4 AC�OWLEDGEMENT OF CONDITIOT�S <br /> The undersigned owner/applicant hereby agrees to hold and save hann� <br /> less lhe City ol Everetl from any and all claims lor damages, costs. <br /> expenses. or causes of action thaf may arise because of installation <br /> • L`����. ���/9 and maintenance ol the improvement or other right�ol-way use hereto <br /> �; `� applied for and furiher agrees to remove same upon notice Irom thP <br /> Approvetl for Const. cti 1e City and to replace public properry damaged Ihereby. <br /> � ��� ��G� <br /> FINAL INSPECTION Date <br /> Approved as ConsVucted � Signature ol Appli ant Date <br /> ��r��� PUBLIC WORKS GePARTMENT WORK AUTHO EG BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200CedarStroat 780 DAYS OF DATE PERMIT IS ISSUED AND I'HEREAFTER IS TO <br /> Everett,WA 98201 BE DILIGENTLY PURSUED TO �;OMPLETION. THIS 2ERA71T MAY BE <br /> Phone:259�8810 CANCE�LED 8Y THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />