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�ir� <br />�aH <br />c�H <br />a.x3cn <br />y zH <br />� H "� <br />'�TJ Fi "�-] <br />� �"� <br />� �� <br />yq <br />p H <br />� C� t7 <br />H�1 G: O <br />y� V C] <br />�g <br />> H lTJ <br />r z <br />�yHH <br />O � H <br />C'] C7 � <br />� r� r <br />za� <br />H O '✓a <br />Date 11/21/91 <br />\\/'is-'��� --7 <br />ApplicatiorFor .. TU PUSTIN <br />PUBLI� 'v1/ORKS PERMIT <br />Print or Type Only `' � <br />'.:; <br />, � �� <br />,:-� c ci � c. <br />� c. <br />_.. �� <br />Applicant <br />DescriGe P�oposed Work <br />Project Address lif knownl <br />a�er�woiksa�,m�n. 9\ CoZ-- <br />siae. o�oi. • 2817 _ <br />Public Wo�ka Fea <br />To�al FCe S - - <br />LC59 FpO� FCC i3id S <br />�,inoao oue � � __ <br />Mailinc] Address� ' �. Gity�� v� Zip Phone <br />i. <br />� -�t e_ t i r'c <br />'rlt � C-I.J <br />��.; 1 1 ' f=1 lll . ` <br />: �: i ll. . .�� ::. (Il .� .' f_l <br />Mailing Addre55 City Zip Phone <br />New duple�: <br />417 A 5 B Pfadi s <br />Attach tour (4) copins of pians for proposed work � Draw t� scalF antl note Ihe lollowing as applicable: <br />• Properry Lines • Centerline o( sireet <br />• Outline and dimensions of all eaistin9 and • Indicate Norih <br />proposed strucW res on the lot • Show any proposed grading chan9es <br />• Existing and proposed ulilities O Show measwements <br />THIS LINE <br />PERMIT CONDITIONS <br />,o � 7. All calla br inspeclion shall be made ^<4 hrs. in advance • phone 2:i9-8810. <br />0� � 2. All work shall be pedormed in accordance with this permit and current City ol Everctt �esign and Construction <br />'�" Stantlards and Specilications. <br />3. Call Lncation lJnderground Service 48 hrs. belore you diq. TOLL FREE NUMBER i-500-424•5555. <br />o"m me <br />-� , �.. <br />a�a. �o <br />�� <br />�m.��! <br />� ���� <br />a1.'a� <br />•qq �, <br />�'� <br />�iVl�l `%- � Z- !o - 9 I <br />Approved for Cons ruction Gate <br />� <br />_� ��.� - � �- � � <br />FINAL INSPEC710N Date <br />ApP�oved as Cor.structzd <br />�PUBLIC WORKS DEPARTMENT <br />,��3200 Cedar Street <br />Everott WA 98201 <br />Phone:259�8810 <br />ACKNOVJLEDG[MENT OF CGNDITIONS <br />LLf <br />� <br />Y! <br />� <br />e <br />� <br />�' <br />The undersigned owner/applir,ant hereby a9rees lo hold and save harm� <br />less the City ot Everett Irom any anA all claims for damages, costs. <br />expenses, or causes of act�on lhat may arise Uecause of installation <br />and mainlenance ot the improvement or other righbol-way use hereto <br />applied lor antl lurther agrees lo remove 52me upon notice from the <br />City� ,an/d �o replace public p�operty damaged thereby. <br />,�r/ .-� l7/� , _., �� � ����'��/ <br />m <br />Date <br />RK AUTHORIZED BV THIS f'ERMIT MUSf DE STARTED WITHIN <br />BO DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COhiPLETION. THIS PERMIT MAY BE <br />CANCELLED BY TtiE CITY UPON P.NY STOPPAGE OF WOFK nN TFIIS, <br />PROJ[CT OVER 90 DAVS DURATION. / <br />V <br />