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IyOH <br />'� <br />k��x <br />Cy H <br />t�x>y <br />yYi-�i <br />�H� <br />���i <br />yVJH <br />�p� <br />HC7 <br />OH <br />H�g <br />47 � Cq] <br />z H [�f <br />�HH <br />N <br />�Cf�/� <br />��� <br />z H (n <br />HOfn <br />�� �': <br />Date �' 91 <br />ApP�icalion For <br />PUBLIC WORKS <br />Print or Type Only <br />/ <br />CJ� <br />PUCIic Wo�ke Pn�mu + <br />T� nACT�yjj r0 c�l"���I o�eeoopi., 91/35177 _--- <br />PER�lIsT <br />� poolicvloixeiee S __ _ <br />�oVd F'oa - <br />les:�Aop��FecPmo g ' n <br />o�ia�«. o�� 5 / b — <br />qq���y ' 754-97'4 - <br />Ron 61ay 'Powinq 4101_ Ruck�r Ave �veYak�; W � y .,' �i� , phonc <br />Owner Mailin9Add:ess � � - .. ,, <br />_ � �. �. . ' �. _ � . . . 246-1506 --- <br />Randall J. Mi:nson (Arch) �.�Y Zi� pnonc <br />--�—y��� Mailing Addre=s <br />�onstruct new autu/towing shop <br />Describe Pioposed Work <br />project Address (il knowr) <br />Attach Icur (4) cOp�es ot plans lor P�oposed work � Oraw to scale and note � Ceo�te�iine of str�Pel a�1e <br />• PropertY Lines • Indicale Norlh <br />• Outline and dimensio�s ol all exi,tin� ind y Show any proposed 9rading chan{)es <br />proF�sed ��ruclures un ihe lot � Show measuremen�s <br />• Ezisting and proposed ulilities _ _ <br />LI <br />'o_ pERMiI COIJDIilONS <br />1. All r,alls lor inspeclion shall be made 24 hrs in advance � Phone 259•8810. <br />��1 2. All work shall be pedormed In accordance wilh lhis permil and current City ol Everett Design and Construciion <br />Standards and Sper,ii!cations. <br />3. Call Locati: n Undargroand Service 4B hrs. belore you dig. TOl L FRE5 NUMBFR 7•B00•424•55.: . <br />�/ � t`> - �<.�.-. .� L<� c��,�,. �'. - `/%' . . .(- �.'i � .., ' <br />7, ��%G :�' . � � <br />�/<; t;{� :�-/� %"� �/�/,; _' �`,_ %,� ��'/ <br />,•��i o�ed <br />FINALINSNt <br />,qpproved as i <br />�� <br />PUBLIC WORKS DEPAR7MENT <br />3200 Cedar Slreet <br />EverelC WP 98201 <br />Phene:259-8610 <br />ACKN0INLEUGEIdENT Of C(iNDITIONS <br />The m�dersi9n�d owner/aUPlicaN herehy a9�ees to hold and save harm- <br />less Ihe Ciry ol Everelt ��om any and all clalms for damn3es, cosis, <br />ezpensrs-. or ceuses ol aclion ihat may arise Lacause of inslallation <br />and maintenance ot the improvemert or oth^� ��'.h4of�way use hercto <br />applied lor and luriher a9�ees lo remove 5a" .Po� ��1ice �rOm the <br />City and to repl�ce publ�c p�operty damaged tnc��:bY <br />���� -� >>F�J9� <br />`Jl ilf. <br />s�--- Date <br />Signature ot Appl�can� <br />90R�KAYSTOF DATE PERMIT ISEISSUED AND THFREAfTER ISHTO <br />BE DILIGENTLY PURSUE� TO COMPLETION. THIS PERMIT MAY BE <br />CANGELLED BY THE CITV UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVHR 90 7AYS DURATION. <br />