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Date.�N!SfL_� PUEIIt Worka Permi�s �_ <br /> l BItl9�Dept r <br /> ADPlication Fcr <br /> E�iJBLIC V�l�t�l{S PERMIT FubTolsFe9Fee $ �tG7,� <br /> Ld4J AOO�FE9 qA E •9 � <br /> ��.1 � <br /> � 0dlellLP'.�U] w1�� .-- <br /> Print or Type Gnly — �-- <br /> /�c�c'Pi_ �' l0 67�-s <br /> Lester L. W�ar 12902 Hight+ay 99 5 Bverett 98204 7h�j-28�8 <br /> Owner Mailing Addrer.s City 2ip Pnone <br /> Same <br /> Applieant Maiiin�Address City Zip Phone <br /> Describa Proposed Work Inetallatian of SLorm newer, 31de curb, gutttr and street <br /> —. _ � <br /> ProjectAddress�i�known) �DOth and flully Dr. Everett. Wa. _ � <br /> Attach four(4)copies of plans ior proposed v.vrk- Draw to sc�le and note ihe following as applicable: w� <br /> • Proper!y Lines S Centerlin=of strcet � <br /> i Outline and dimer.sions of all existing and e Indicate North <br /> proposed structures on the lot • `row any proposed grading changes <br /> O Exi;ting and proposed utllities • Show measurements � <br /> v�w�� <br /> DO NOl'J�'RITE BELUW Thll�LINE � <br /> PERMIT COYDITIONS . <br /> t. All calls tor insp6ction shall be rnade 24 hrs in advance-phone 259-@81 5. � <br /> 2. All work sh=11 be performed in accordance with this permit and current Cily of Everett Design nnd Constrection <br /> Standards and Specifications. <br /> 3. Call Location Unde�ground Service 48 hrs.before you dig.TOLL FREE NUMl3F_P. 1•800•424•5555. � <br /> l ��,� i'���s .�/'.-''�-�,�_� 3`�`83 � <br /> � � <br /> � <br /> � <br /> � <br /> � <br /> A::I«JGWLlcDGEMENT OF CONDRIONS <br /> The w:dersioned ownFNaF;:�:a�-�l imiaoy agrees to hold arnl savc f;arm- <br /> less the City ot Everett from any and all claims for dama9es, costs, <br /> �.xpenses, or causes of aclion lhat may arise bccause �( installatiun <br /> � /��� and ma!ntenanco of the improvement or other riy�i�-ot-w;ry use hereto <br /> applied for and further a�rees to remova sam:� upon rr,tice irom the <br /> App ve for�Co r on ' �Date Ciry and to r plar,a public property damaged thereby. <br /> � - � �y L �c, � � �� <br /> FINAL INS ECTION Data _ �%' _-t—"'"� � � — — <br /> Approved as Constructed naW re of P.policai; �'��« <br /> everett PUBLIC WORKS DEPARI'MEN7 WORK AUTHOR ZED BY THIS PERMIT MUST BE STARTE7 �.iTF�,N <br /> 180 DAYS OF D4TE PERMIT IS ISSUED AND THEREA�IcR �S TO <br /> � 3200 Cedar Street BE DILIGENTLY PURSUED TO COMPL[TION. THIS PERMI7 MAY �E <br /> Eveiett,WA 982U7 CANCELL'cD BYTHE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone: 259-8815 PROJECT OVER 90 DAYS DURATION. <br /> r; <br />�;w ,.«�-...- _ ,.....�,�.r._.,......--s-..,..., ._,. ,.r�.w.._,_._+.��.�-.. . ,, _��d <br /> ,.�.�y_=� _ � �.�...r:_�v�z � _ _. _. <br />