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■ ■ <br /> Dele ( ' weucwom>omx• <br /> Application�or <br /> � eao.D�o�• <br /> PUBLIC WORKS PERMIT a°;;,°:;� : <br /> i.neoo�F«va 3 <br /> e.aM.o�. f <br /> Print or Type Only <br /> Plan Check No: B 40687 SEPA <br /> Owner APjob�Addreee: 66014GLENW000 P�one � <br /> Owner: CORBRLY CARY <br /> Tenant: <br /> Propoeed Uee: SFR/DECK Phona <br /> AOPlicenl Desc. of Work: <br /> 288SF DECK <br /> DescriEe Proposad Work _ OFFICE SET JOB SET <br /> APPROVED FOR PEFUfIT: DATE_/_/_ BY <br /> W <br /> Prolect Addmss(II knawn) � <br /> Allach lour(9�co0les ol plens lor D�oposetl work-Oraw�o acale and note Ihe Iollowinq ea e00�icable: � <br /> •Prooerty Lines' •Centedina ol slreet 'A <br /> •Oulline and dlmenslons ol ell existlny end •Intlicate NOrth V♦ <br /> proposed struCtures on I�e lot •Show any proposed pratlinp C�enpa5 <br /> •Enis�ing end proposed uillitle6 •S11ow me0sufam9nla M <br /> W <br /> DO NOT WflITE BELOW THIS LINE O <br /> PEFiM1T GONDITIONS <br /> 1.All cnlls for Inspectbn ahell be mede 24 hra In edvence•phone 259�8810. � <br /> 2.All work shell be peAormed In eccordence wllh!Ns permit end cunent City ol EvaraU Daslpn and Cons�ructlon <br /> Standarde entl Speciticationx <br /> &CelllocatlonUntlerproundServlce48hrxbeloreyoudlp.TOLLFHEENUMBEli7•800�424•5555. � <br /> O <br /> PUBLIC WORKS PERNIT 'w <br /> NOT REOUIRED � V, <br /> DV � ' O <br /> D11TE �'''G'^'� <br /> a <br /> ACKNOWLEDGEMENT OF CON�ITIONS <br /> The untlersl9ned owner/applicant hereby eprees to�ald end eave harm• <br /> �ess Iho Clty ol Evorelt Irom eny and ell clelms lor Oemage; costs, <br /> eROenses,or ceusas ol ecllan l�el may arise 6acauea ol Installetlon <br /> and meintanance ol lha Improvemant or olher tlBhbo4wey use hereto <br /> eOPlied lor end lurther epreee to remove eame upon nollce Irom tha <br /> Approva0lor Conetruction Dete Clly and lo replace publlc proparty dameped iharoCy. <br /> FINAL INSPECTION Dele <br /> Approved as Conslmcted SlOnalura ol APplicenl Dete <br /> � pUBLIC WORNS DEPARTN.ENT WORK AUTHOflIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 7200CeEu5trael 180 OAVS OF DATE PERMI7 IS iSSUED AND THEREAFTER IS�TO <br /> Everotl,WA9BY01 BE DILIGENTLV PURSUED TO COMPLETION.THIS PERMIT MAV BE <br /> P�one:259�8810 CANCELLED BY THE CITV UPON ANV STOPPAGE OF WORK ON TMIS <br /> PROJECT OVER 90 DAVS DURATION. <br /> � <br />