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�. �_ _. � ��.__._ .`_ .... _T �.T _ �f. ._�.�.-..� <br />/ ` 1 ��j / � . <br />Date��//�� 1 1 �_✓Vi� 1 . . . ��]��%� <br />� r'— , Puehc WOAaPerm�� � �` <br />AppliWli�Fa, TO POSTING t- — B1OpOep1._� ' <br />pUBLIC WOR�CS PERMIT ^°°°°•°°��.�°° <br />,o�.� �e, s <br />� «inecottFeevue 5 <br />� t �' �i rb'vi� r�� `�g�iv'r'i� ��,6.:o�e SZG�— <br />Print or Type Only � o� o o vi o pa o. o o. o <br />y1 � N.CAI�+(NI [-N N �M�(MI � `.ryi � <br />N _ <br />vt`'i5y� j�� o�1t�iics.+��LpIP�G3yN. j::� <br />Gi [7 ^ Ul = [.i [� ] 4 [] Y N .-� L� <br />�escribe Propose0 Work � �/ � �1/!%�7_ ���� <br />ProleclACOress�ilknown� /ZUJ /�-�wvt��i� <br />Atta[h IOu� (4� co0ies 0� plan5 �o� proposatl wOrk � Oraw 10 scale <br />�� • Pmperty Lines <br />� • Omlme antl dimensions ot all existing antl <br />I proposetl slmC�ures on Ihe Ioi <br />• Exislin0 and proposed utililies <br />no�e ihe lollowing ds app6cablC: <br />• CeNedine ol slreet <br />• Indicate North <br />• S�ow any proposeC Orntling changes <br />• Show measuremenis <br />PERMIT CONDITIONS <br />1. All catls lor Inspection shall be made 24 hrs. in advance • phone 259•881 O. <br />2. All work shall be pedormetl in accardance with Ihis permii nnd cunent City ol Everett Design end ConSimction <br />StandnrOs antl Specilicntions. <br />3. Call Localion UnCergrountl Service 48 hrs 6elore you tllg. TOLL FNEE NUMBER 1•800•424•5555. <br />4� I� 12EG'f" r\LL �rAr pe��NACE -TO /iN IN4'IL'TIZAiiGN <br />T2eNcFi ����ED �viT+1 ��/tiFlr� De.Air.1 �OLK. <br />�� �On���„I k'��i� al� �a�J;-i�'ic�J QI Si�+r;/ -� ���'i� <br />��,. <br />�� <br />� <br />� /%����_ � "�f-9Z <br />4pprovetl IOr Can:IryClion Oa�e <br />s <br />..�.� �-� a� � 3 _ . <br />FINAL INSPECTION �a�r <br />AP��ovetl as Conslructed <br />��,�;� PUBLICWOFKSDEPAPTM'cNT <br />/o�� 32�JCedur51ree1 <br />���n EveicltWA38201 <br />Phmc. 259�8810 <br />W <br />F- <br />� <br />�1 <br />� <br />Z <br />O <br />r <br />O <br />a <br />ACKNOWLEDGEMENT OF C.7NDITIONS <br />The untlersignetl owne�/appliCani hereby a9rces to holtl and save haem- <br />less Ihe Cily oi Evemtl irom any antl all claims lor tlamages, cosls. <br />e�penses. or causes ol action ihat may arise because ol inetallation <br />antl mainlznanco ol Ihe impmvement or olher n9hPobwny use hereto <br />e�Plietl for antl lurther a�rees lo remove same upon nolice imm Ihe <br />Cily antl �o replace public.property damaged �hereby. <br />�� � ����-��/�� _r /li.-v� <br />Signamre of Applicanl Datc <br />WOFK AUTHOfiIZEO BV THIS PERMIT MUST DE STARTED YJRHIN <br />180 DAYS OF DATE PERMIT IS ISSUED ANU THEREAFTER IS TO <br />BE DILIGENTLV PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLE� BY TME CITV UPON ANV STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAYS DUflATION. <br />