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� -�s ZR-4 �z 3 <br /> 7-1�1— 2 a�oecwo��aParmn• - <br /> n ale--9 97'39� <br /> ApplicalionFof TO POSTlNG_ 7_q _93 Biag.Deo1.• _ <br /> ��� PU�LIC WORKS REReVIIT , °"'T�,�F��`eO 5 <br /> A�� I �css aooi vcr a.ra S <br /> � a.,i.��,...o�.. 5 G� <br /> r�� Print or Type Onty <br /> y H <br /> O� H� ldilliam W. Miller PO Box 1116 L nnwood WA 98046 743-3213 _ <br /> N H Owner <br /> Mailing Atldress Gty ZiP Phone <br /> Hx tg'' <br /> t�J O C�1 Rick .Tones 259-4341 <br /> O H� Applicant MaJmp Address Clty Zip Phone w <br /> H �g <br /> �" n new construction SFR � <br /> H Describe FtopoSed Work <br /> 9 H� <br /> r x <br /> g "y W <br /> � <br /> H <br /> C� C7� <br /> (8?_Z - C-'r.lcatA�o avE T.�t �, � <br /> "Ez�j �� Project Address�il knownl � <br /> 2 H tn � <br /> H O V� F,I;�c" lour(4)�oPies ol Pians br proposr.tl worh- Draw�o sCale antl notc Ihe tolloWing as apphG�:�le. � <br /> � • Property Lines • Centerlme of street <br /> • Outlme and dimenvons ol all ex��n.n9 and • Ind�cate Norin <br /> prOposetl SVuCtur¢5 0�the I:t • Show 3ny ��en;�sed qraU•�i�7 :h:ing�.�s <br /> • Eai5iin9 and D�Oposed utilitie; • ShDw meas'.ueme�n� M <br /> W <br /> ���� DO NOT WFITE BELOW THIS LWE O <br /> w. � PERMIT GONDITIONS � <br /> � � 1.All calls�or inspectlon shall be made 24 hrs.in ativanr,e-phone 259•881 O. <br /> 2.All work shall6e pedormed in aecordanee wilh this peimit and currenl C�ly ol i:v�rett Design and Con;truction <br /> Standards and Specificalions. � <br /> ,,. � 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1•800-424•5555. <br /> E� � / <br /> ` �' � =�1 a �s ti�- /' 0 <br /> �. COM� �j wi 9 l�C'c.; C��T�d,7S d � ��i� <br /> 'w ��� / l� <br /> '-= #lZcJZ-2S�• ♦r^ <br /> ..�.d �. �s;d� -f�./ e✓i';�..Q.'s�a�°r',�,�i a.�e l,'�,�ed � V+ <br /> �� �, d/�/vtwcc O/� <br /> 7� Z . �-Gtr� c�an��c .� eX i 5�`-��7 y � - 9��'v�1 li <br /> / <br /> � �' �'o✓ % f M�I� G.e ��r��•e�/ 6� fvdl7 I{/cv� .�-i1'�az�Y <br /> I�' � �Q., ACKNO�VLEDGFMENT OF CONDITIONS <br /> + ItY <br /> �,' _ Th�•undersignedowneVappliwnthcrehyagrees�oholdantlsavehainr <br /> Iess 1he Cdy ol [verelt Irom any and all claims inr dama�es, cosls. <br /> e.nenses, or causes of aclion that may arise bacause ol installation <br /> /' L��, �_�7��� and maintenance oi lhe impro+ement or other righ4obway use hercto <br /> �,��� � Cd.X�C� / ppplied lor and fudher a�rees lo remove same upon notice Irom tha <br /> �pr.rcr�d lor Const!Uc,Qon <br /> f Datc pity and to replaco pubhc property Jamaged ihereby. <br /> !�%lY� i- — �-c %3 / ,r' 7 `� <br /> � <br /> Da�e �',i•�i—. N,.,.. 1 /?�%,o <br /> FINAL WSPECTION Dalc <br /> Appioved as Consiructed S�gnaWre qf"Appliwnt <br /> ��qy--��_ WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> !�;�j PUBLICWORKSDEPARTMENT 180 DAYS OF DA7E PERMIT IS ISSUED AND THEREAFTEF IS TO � <br /> ���� 3200CedarStrcol BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY B[ <br /> Evcrett.WA 00201 CANCELLED BY THE CITY UPON ANV STOPPAGE OF WORK ON THIS <br /> fhonc'269�8810 PF70JECT OV[R 90 DAVS DUFATION. <br /> � <br />