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De�e � woi.<wem vmm�• <br /> eao o.o�• <br /> APO��catlon For <br /> PUBLIC WORKS PERMIT "°r�°�:"' _ <br /> �....ow...r.a s <br /> a.�.M.o.. s <br /> Print or Type Only <br /> rapan �n�cK Not 8 3/7Y9/1 56pA Zip Phone <br /> Owner �pJob�AddC ut 8016�N90LSN DR <br /> Own�r: NON6YM11l7 BLIZABfiTH � <br /> T�nsnt: <br /> ApPlicent Piopo�W U�a[ CARPORT ZIP Phone <br /> O��c, oE Works <br /> 3305F CARPoRT <br /> DescrlEe ProposeE Work Ot�IC@ SfiT <br /> JOB SET <br /> 11PPROV6D FOR PEAMIT� D11TE_/_�_ BY_ <br /> W <br /> Pro�act AtlCress�il known) � <br /> Aitat�l0ur(4)topiBs oi plena for proOoseE work•�raw to 5tale entl not0 t�e lollowing as applitable: � <br /> •Property Llnes •Canlerline ol street <br /> •Oulline ena dimeneions ol ell eRistlnq anE •InCicate Norlh <br /> proposetl;�ruclures on t�e lot •Show any propoaetl qreuinp c�anqes <br /> •EMialing and proposetl utllitiea •Show measu�ements M <br /> W <br /> DO NOT WRITE BELOW THIS LINE a <br /> PERMIT CONDITIONS <br /> 1.All cella lor Innpectlon anell ba made 24 hn.in advance-p�ona 259$810. � <br /> p.Allworks�allbepeAormedinacco�dencewll�IhlspermltanticurtentCiyofEverellDesiqnentlConslruclian � <br /> StenOerde end Specifiutlona <br /> 3CeIILocalionUnderprountlServiCe48hre.6eloreyoutli&TOLLfNEENUMBENI-80O4245555. � <br /> �� ` � <br /> ��ip./�st. L mT/sv��,�.„.�' , ;:f�'y-C(c�.t <br /> b h � � <br /> � '` � <br /> C <br /> 0 <br /> ACKNOWLE��EMENi OF CON�ITIONS <br /> i�e undersl0ned owner/applican��ereby agrees 10 holG antl save�arrt <br /> less t�e Cily ol Everett Imm eny end all claims lor tlamaBe; cosf, <br /> eapense0. Or causea ol ecllon t�ai may atlse betause al Ina�elleli0 <br /> antl meln�enante ol lhe improvement or other rlpM•ol�way use herat <br /> applied lor anE luh�er aBrees to remave same upon .�olice Irom 1� <br /> ApproveE�or Conslruclion Dele City and lo rep�ace public property damaQeO I�ereEy. <br /> FINAL INSPECTION Date <br /> Approvetl ea ConSImCIOE SiB^atum ol ApD��Cent �ate <br /> WORH AUTHORRED BV THIS PERMIT MU3T BE STARTED WITHI <br /> PUBLIC\VORKSDEPARTMENT 100 DAYS OF DAiE PERMIT IS ISSUED AND THEREAFTER IS T <br /> 7Y00 CeOsr Stresl BE OILIGENTLV PURSUEO TO COMPLETION.TMIS PERMIT MqV B <br /> Evarott WA 9B20t CANCELLED BV THE CITY UPON ANY STOPPAGE OF WORK ON THI <br /> Pl�one:t5B-BB10 pqOJECT OVER 90 OAVS DURATION. <br />