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ac �./ <br /> Date 6/14/94 � �� P�STIr�G AUG�� � 2`�9 <br /> Pub��c YfarFs Pnrm�l� <br /> G�nn oeo� . 44666 <br /> Applir,aro n For _- <br /> PUBLIC WO�KS PERMIT °"°',°,'`°�`_`�° <br /> r�„���� s <br /> � lvss Annl r�� ':a�,:i 5�- <br /> � o o � c� v� g � � o � e.,�.,���.c,�� S.��D� <br /> Print or Type Only o. . . . <br /> y� r� � oo � o vi oo ,o <br /> �:: in° �w � � '� u�i � w � iri � <br /> w N .+ <br /> M & D Builders Inc P03Bo�868 Marysvi�e � 653�2055 <br /> OwnCi \^�. �•irn; uPc:.a--�� J�:fa.+ \ " Li:: Phnne <br /> .p 'O (D S f7 �V[ 3 tl410I�J r+ [� <br /> ..� � O � C] � tn � OF- O � r' W <br /> Owner o oea'� n. zn� mo � � au�i �-� --- - -- --- <br /> Applic0n� ��. In� ��1�idr,.5., ,�,it�� Z�� Phnne <br /> DescriUePropcsedVdork _______New house ____ ___ _ __ <br /> -------�--- ---'----------- <br /> ---- -- -- --------- -------- W <br /> Prolect Address(if knowm ____ SL3P_EZID.____._________. LOt Z__SP 16_84 __ _ � <br /> Attach ieur(A)eoP�es of Plans fin ProPused Lwrn � Dia�•: ta �;�..d.. .u,,i ni.L•iha 'ollutivmg as aPUlicahie: � <br /> • PrOperty Lines • Centerlmr. nl stre�t ♦^ <br /> • Outline and dimensons ol all exishnq and • Inr.icale Nor�h V� <br /> proposetl strucWres on the loi • Shev:any r.renosed qran,�nn ch.in:�os <br /> • Existing and proposed utilities • Show measurements M <br /> W <br /> DO NOT WRITE 6ELOW iHIS LINE O <br /> PERMIT CONDITIUNS <br /> 1.All calls tor inspection shall be made 24 hrs.in advance-phone 259•881 O. � <br /> 2.All work shall be pertormed in accordance with Ihis permit and current City of Everett Design and Conslruction <br /> Standards and Specifications. <br /> 3.Call Location U�derground Service 48 hrs.belore you dig.TOLL FREE NUMBER 1-800•424•5555. � <br /> � �QC.'`e � �tcc. Q�2�6�'✓ /'�fOY�" "`�" O . <br /> / CG� ��c.eX` �� �� �jo�.T�, ��..z� , <br /> \T � <br /> Q v � <br /> � � � � �� .� e � a <br /> 1 �OI�L �) � �J✓` <br /> 1�� � V9� LI�/ �ri <br /> �I � ,� �l � ��� ` ACKNObVLEDGEGIENT OF CONDITION�' <br /> � ,�1 O U <br /> Y` i h��u�d��r�iqned o�vner!.lpplict:nt hereby agree5 to hold n id sace harm� <br /> - "�- "�-�-i ioss the Cdy o� Everett Irom any ,nd �II claims lor Aama9e:,. ccsts <br /> // ///� ; expenses o� causes ol ar.Uo� Ihat m�y ans� Uecause of installation <br /> _-------_--=1��((� ��.,�/�Y�..' g/�U I ,lni1 m:�interanr.e n! tne improvemeni o� other n9ht-obway use herelo <br /> �%: L r � ! apN��*�� �or ;ind furthar agrees to remove same upon notice Irom the <br /> Approved fo fnstr tiop, �:���' ' G!v ai;d tn �e•placa P�blic pronerty d�ma tl thereUy. <br /> i <br /> . " 1_ zr-7���i� � . <br /> , <br /> FINALINSPECTION �'« 'i, — <br /> AGProved as ConslrudcA i/F3 i�atwe ot Anpi�cant Date <br /> �Ale� PUBLICWORKSDEPARTMENT "'I '•�'�°V( AUifiORIZED BV THIS PERMIT MUST BF STARTED WITHIN <br /> I t90 DFYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200CedarStreet BE DILIGENTLI' PURSUED TO COMPLETION. THIS PERMIT t.7HY BE <br /> Evcrett,WA98201 I (_.aNCELLED BY TNE CITY UPON ANY STOPPPGE OF WORK ON THIS <br /> Phonc:259�BB10 � Pqp,IECT OVER 90 DAYS DURATION. <br />