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PUBLIC WORKS �',�° - , � ; - <br /> PuGhc YJoiks Permn :+ - . <br /> RERMIT :;.�: �:�-__:�;=. <br /> Butlding Permit a Uz-5 <br /> PU3LIC WORKS D[PARTt.1EfJT Planning Relernnce a <br /> 3200 Cetlar Sireet Public Works Fee S �- -' � '���� <br /> Evcretl,WA 98201 <br /> (425)257-8810 Guarantee S <br /> Olb'NER WVdE ' ,.� .� ' . APPLICANTNALIE .. .`.__�.... 'v.��'•t_L' <br /> allonou�ess ` �E�- FETER � r.nuncon�ss ` _ t _ <br /> �_^,Tf: AV� ?'�r. �- _ _ _-t;., ��/;9�Mn� �_ <br /> --`�'�Vi�e. i9;i �� - „ r.'J�h��TT iiA . . .. - - <br /> ��.�L <br /> PHONE -,_:4G! .::1��;� PHONE- a�;� ��_;:jr'i?F <br /> iA%PARCELID. a �? li; PROJ[CTAGD ES$� �,__; ._.,i.j_,�:.._ .�{'1" <br /> �Ii�Jyl)'�b�U... � <br /> DESCRIPTIONOF -I�.._�.�L.S'1:Y�T r-r'y1T - ._'i.`-L � �i:'� YC �. .'i�1:Y:..r . <br /> PROPOS[D'�,NO�K. <br /> PERMIT CONDITIONS <br /> �� !/ 1. All calls(or inspection shall be made 24 hours in advance - phone (4?5) 257-8870 , <br /> ' 2. All work shall be performed in accordance with ihis permit and current City of Everett Design and Construction <br /> i� � Standards and Speci(ications. <br /> / 3. Call Location Underground Service 48 hrs. belore you dig. TOLL FREE NUMBER 1•800-424-5555 � <br /> �/ .r .:l . ,at'�,3 �iF"]lti�l :1C.Nw3�� •.Jt":NY� C.a�.' W�_i r:� �i._l::i�:1fl (Ri.l:;t IJ�. E:,�'����.; '�i� . ,. � <br /> _ _lil'l.nit. OY� i^CriCY�-t4+ . _ . �//�� <br /> . :JL'LVt_W3Y cl[Jr'rpa�::l illll�:t ZJP ,='Jll'::`Y'Ll�:t.ytl ��i'r' �'i :'f O� E'✓�T�t.`.- j�cl:�l�a:.��: V/ <br /> = : 1r: #3u; ; �=o��� �ttacli._:d) <br /> i'., . 17c.�_[1]@St. d C1i�lf� IP,i�ti•'.1::iT �p _��Vi�_'W W1L�1 `.�!]�3 t'LI7��C VjqC:':'o _.?�i.>': C:-.1L � <br /> , _ _ '.1�.1�. 1�- ��-1-iL31. I'" y'_J ' C_f-?y _':� 1 :��:UI'.. :: � �� �.::_:�:ij W1:2:( . � <br /> %, �reas r�of useo� �'o� dr�vtwtiys �i�.lL 6z s'c�cb� c�r�h -7 <br /> yr�SS {'-o•� 4 n�cc sf�e� aPPeara.,ce. � <br /> ��. 1�rivFways s/d !L .� loca�e� Per alfacheo' o�rQ��iny o <br /> i�3�02 � <br /> ,I: f:�c� / � <br /> � <br /> � <br /> � <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> � The undersigned o�vner/appGcant hereby agrees;o hotd and <br /> ' 7 / Q� save harmless the City of Everett from any and all claims lor <br /> appmv ror Consimci�o;� Da�e damages,costs,ezpenses,or causes of action that may anse <br /> because ol installation antl maintenance of lhe imprcvem�nt or <br /> Iother righhobway use hereto applicd fer�nd furthcr agree��to <br /> � remove same upon netice irom the Gty snd to reptace public <br /> FIIJAL INSPflCTION pmperty damagetl thereby. <br /> ApPmvedaSConsiructed Date _...._______ <br /> Signalure ol Apphcan! ���r <br /> in�K,�.�����i��I�,Ei,;�Y�f'q511E1�7dY C�'E C.NCELLTG9 CE 1HETCR/�UPON aN�Y S OPf GE Of VJOIRK ON�THNO PROREC OVER 00 BE DIDUR TIONPURSUED <br />