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� <br />TYPE OR PRINT ONLY <br />Describe Proposed Work <br />' �plication For <br />PUBLIG �.ORKS PERMIT <br />PUDLIC �YORKS DEPAqTMENT <br />3200 Cedar Street <br />Everett, WA 98201 7.59-8810 <br />Mailing <br />�'0 POSTING NOV 2 4 1991 <br />Address <br />r� <br />PROJECT ADDRESS (if known) �:: <br />Da{c l/21j9% / <br />Public Works Permit # G7 �/�i�� <br />Building Permit # Q 9 g <br />Public Works Fee $ C .O — <br />Zip <br />� 22 <br />rnonz <br />Attach four (4) copies of plans (or proposed work Dr2.r to scale and note ihe following if applicable: <br />•Property Lines •Outline and dimensions o� all exis�ing and proposed structures on the lot •Existing and proposed utilities <br />•Centerline of street •Indicate North •Show any proposed grading changes •Show measuremenis <br />�--- —..--"'— <br />PERMIT CONDITI9NS: <br />1. All calls for inspection shall be made 24 hours in advance - phone 259-8810. <br />2. All work shall be performed in accordance with this permit and current City of Everett Design and <br />Construction Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. <br />� ..�,i;i <br />. <br />•. ,::t tl:!!ifl".�If:�t! il.,qr.i_ ��I:"?;iJ i,'i� `.�'Pl�:ltl i-� f� �' ':(!ti t':CIIIT :11:.'� I'1�tiP i . pl !il ` i1;i'' <br />i;�fllli�•!1(•:! :Lf �If:b�' �0'rlll ;LINL'4`il i cU�)C �?i8i)1.`(I 1;1 1i115 17^R�l!i! 7 7D: 1(lill[f�[I(al (1':'.Ili'0 itl'<Ill l�i <br />�.� _ :6.��� ; IL._.: r � z� ,, �}�� �i.'�. � ��.�,ijl Ii�r �!li? �� i�.�uil�i:•iinri iln/ ii -.-..�f i�i!i(1 2t7 ir'f IO �In' �iJ6.��. <br />'r:I^��•;�•:1;�1-'••I'fO�.I::L�I;�:RP,. _�:111f��.,t�I��.1S:Uf�:i:�:!fH�3111gn''C!(O:'�li:i11'!'Ot'O�i�:(III•_'.?!'i'If:�l�'r; <br />Z <br />O <br />� <br />v/ <br />1� <br />�a <br />_, i <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned ownedapplicant hereby agrees4o hold and save harmless <br />the City of Everett from any and all claims (or damages, cosis, expenses, or <br />causes of action tha! may arise because of Installation and maintenance o( <br />the improvement or other right-of-way�use hereto applied for and further agrees <br />to remove same upon notice from the City ar,d to replace public property <br />damaged thereby. <br />Signature of Applicant Date <br />WORK AUTHORI2ED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE FERMIT IS ISSUED AND THEREAFI'ER IS TO BE DILIGENTLY PURSUcD TO <br />COMPLEfION. THIS PERMIT MAY BE CANCELLED BY THE CIN UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />' �.7;'��; <br />"::i; <br />:i� `, <br />