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._.. , ._ ..__r.. . <br /> e.!y. ��tM�'V��/YWi\'i(i]I.��.l�'�'�"�i'..�����4fi^'_ti�R��MY��!"'.�-..w�.�i+�.�.•�J�r� <br /> , �.. , . � . �....r,�,.. ,y .,- ,p.� . ,.. .- ... ... �.:.�M..�.vyl.�►�(r..,n^�i".y�o... <br /> -� F- 1 -�;;;=�{'_,,. .. , <br /> DZtQ 9'S'91� � ' ?�..'_� PuEnc worws Perm��� � � 9 � _. <br /> �, Q PQ���� �� aiea.oao�.t 91/27649 <br /> PUBLIC WOR� PERMIT ' <br /> PubGc Workf.Fee � <br /> Tolel Fen � S <br /> ' Leaa Apo�Fee,P�id S� <br /> Print or Type Only � $ $$ $ � $ g � u� � � e.�.��Bo�a s <br /> � � M �N � � � � R � � � <br /> IRod Niaholae 16000 Mi 1 •�Blvd � 0 Mlll Cr�e�c 98012 337-6611 <br /> Owner MaiNn�lddr ,""„ � CitY � Zip Phone <br /> Curt Jot�inwn o a � � �S5 + � � � �' � m � c'3 ]37-47�3 <br /> � <br /> Applicent Maiting Address I � City Zip Phone <br /> ' i <br /> Describe Proposed Work aw oofl�t=uuOtloQf Qup1�7t <br /> +�3 _ W � <br /> Prolect Address p(known) :: U l e:��vpO -1 ��L�l� �. q <br /> Attach four(4) coples oi plans tor proposed work- Draw to scale and note the lol�owing'ys applicable: � <br /> • Property Lines � � Centerline of street � r <br /> • Outllne and dimensions ot all existing and • Indicate North � <br /> proposed structures on the lot • Show any�proposed grading changes <br /> � � � � Existing end proposed utilities • Show measurements <br /> ""� DO NOT WRITE BELOW THIS LINE � � <br /> PERMITCONDITIONS O , � <br /> 1.All ceNs for Inspection shall be mede 24 hra.In advance-phone 259-881 O. � � <br /> 2.All work ehell be peMormed In accordance with this permit and current City of Everett Design and Construction ' <br /> Stendards and Specificatlons. <br /> 3.Call Lxation Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1-800-424•5555. � <br /> q � T�J t�� t ; n e a�I ,�oo�-to I° �d c�- ,ar.wa.,�. dr�,,k��-� <br /> �S +1 :.:-�v.vl 51�+� ,�J✓u�l i c�c c� raJi_ S rO'✓'�" p kcl-' O� <br /> � O � <br /> � ' <br /> � <br /> O <br /> a <br /> �� ACKNOWLEDGEMENT OF CONDITIONS <br /> ��,` The undersigned owner/applicent hereby agiees to hold and save harm- <br /> less the City of Everetl Irom any and all claims for damsges, costs, <br /> expenses, or causes of ar,tion that may arisa because of installation <br /> C✓., n 10_I�-�� and mainten�ce oi the improvement or�,ther right-of-way use hereto i <br /> �-��'�" apPlied tot�abdiJurtrer agrees to remove same upon notice Irom the <br /> App�oved far Coostruc ion Date Ciry and.to-ephace�public property damagod thereby. <br /> � <br /> • " /,: /. <br /> ��' i <br /> � � � � /: /, 1�)'� ;��-/ <br /> FINAL INSPECTION Date � - � <br /> Approved as Constructed . �-'SignalGre ol Applicant Dale <br /> �� PUBLIC WORKS DEPARTMENT WO4K AUTHORIZED BY THIS PERMIT MUSI� BE STARTED WITHIN <br /> 3200CedarStreet 780 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO � <br /> Eveiett,WA 98201 BE DILIGENTLY PURSUcD TO COMPLEfION. THIS PERMIT MAY BE � <br /> Phone:259•3P�t� CANCELLED BY THE CITY UPOY ANY STOPPAGE OF IVORK ON THIS ' <br /> PROJECT OVER 90 DAYS DURATION. <br /> c <br />