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.- � <br /> PUBLIC WORKS PERMIT °Ns ����` .� <br /> � PUBLIC WORKS DEPMTMENT P�d�Ac Wala Pertnk N � <br /> 9200 G�dr Strestg.y�y� �y� <br /> Ev«�tl�YVI^8201 25 �I/11 Z 4 1� BuNding Pertnft It <br /> 7YPE OR PRINT ONLY TO POSTING ,—.---- ����s ,qp� <br /> rw.!sraw� 6Puw►.I� �-�..� 7.L �'� t 4�f't 5�+� E w{�y sr�a..E_,W¢ 'l�tfi7 �6°�Cs�`sls.f <br /> ormx MrlhipAd6e�s CMY �P � <br /> � WLO �WI.S�N. 4�+6�� lTK �S�I��CL <br /> nPWicant Ms�rq Aad�w cnv �P � <br /> o�sc���r�o�d wor� �. t�� s-�w E� W <br /> � <br /> � <br /> PROJECT ADDRESS(if known) ��"T ���bN�("'1 ���°'�� � <br /> � Attech four(4)copbs ol plens fa pq�o�sd wak-Dnw to scab eiKf note tM MMowinp M eppNceWe: � <br /> •Propeity LJnes 'OutYne md dNnMabns of eN�xMinp and puposed structuras on ths bt 'EzMinp end proposed uliHtba O <br /> `Centerline ot st�eet 'IndkMs Nath �31wW�ny proposed predkq clwqa '31wv+rtbew�emenb � . <br /> 0o nioT vuRr�B�ow rHis uNe <br /> PERMIT CONDITIONS: Z <br /> 1. All calis for inspection shall be made 24 hours in advence-phone 259-8El10. O <br /> 2.All work shall be perfortned in accordence wkh this pertnit end curte�t City oi Everett Design end <br /> Construction Standards and Speciflcatbns. <br /> 3. Call Location Underground Servk a 48 hrs.before you diq. TOLL FREE NUMBER 1-800-42�-6666. � <br /> 4 . s�d� �� P.� s�d ��o i - ��3 . � <br /> 5 Cu il 33q- �4o3 ,,�r ih3��on . � <br /> ?.C-c;-9a 3:0�'r'ri a <br /> li 4830� <br /> Pld/FiVtd �0.00 <br /> PW/I�S;' �G.00 <br /> TO';_ 40.00 <br /> CASI-� 40.00 <br /> ;, . _�..,. <br /> nciwow�oc��rr oF cowomaNs <br /> � � G �U � � rne undersqned ovme/�epp�ir.ant neiehy agrees ro tba and aave�wrr�l.a <br /> ths City of Evertt from any and all cWms for dartrpM,coab,expenses,a <br /> Approved tor C s dion . De e �8�����^�Y arise becaum M instelletbn nd mdnMrw�cs W <br /> / the Nnpovertient or oMs ripM�of•way use heieto eppNW faand hrMix epMs <br /> to rsrtaw aeme upan notfce hom the CNy and to replecs pubNc propMy <br /> /�'C� S�7�s c�„ec�me�r• �8. �t-t� <br /> FIN.iL INSPECTION Date � ✓ / . � <br /> Approved as Constructed � <br /> M� <br /> S�gnatura o AppHeant . D�es <br /> WORK AUTHOHIZED BY THIS PERMIT MUST BE STARTED WIhIIN 180 DAYS OF DATE PERMR AND THEREAFTER IS TO BE DNJOENTLY PU9SUED TO <br /> COMPLEfION.THIS PERMIT MAY BE CANCELLED BY THE CfTY UPON ANY STOPPA(iE OF ON 7H1S PROJECT OVER 90 DAYS OUMiION. <br />