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ARKS <br />For <br />OTL'7r PUBLIC PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 259-V810 <br />TYPE OR PRINT ONLY <br />U (a <br />Mailing Address <br />Public VJorks Permit It <br />Building Permit If <br />Public Works Fee $ 2,9 <br />sa <br />11 'r`e-?L` 3 1 `•r�1 (_ /j <br />Zip Phone <br />(-L V✓`-e <br />Applicant Mailing Address City Zip Phone <br />Describe Proposed Work 1_J A H - E eo l- -1 O <br />•r',1 �, � I �J � t �_� i '' ('1 I_j � t, I �� !` l/',� Jl I � � lU, �iin—_ <br />�_ �_ . PUrSL%c K.. C•W <br />PROJECT ADDRESS (if known) — <br />Attach four (4) copies of plans for proposed work - Draw to scale and note the following if applicable: <br />•Property Lines "Outline and dimensions of all existing and propored strictures on the lot -Existing and proposed utilities <br />`Centerline of street "Indicate North -Show any prcposed grading changes •Show measurements <br />DO NOT WRITE BELOW THIS LINE <br />PERMIT CONDITIONS: <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 />Constructicn Standards and Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. <br />IeSPor,��G��e Tor -C 10V,:� <br />e 6L�k &)aL'/_ i7/' ��e c J�j �f/cr heeds fo <br />S �`iis !�/Ord e �sU fef Urre s Q Ai, <br />r <br />T1I <br />() <br />ca <br />0 <br />V♦ <br />0 <br />a <br />O6-03-98 <br />3:51PH <br />0 <br />98138 <br />OVER <br />20.00 <br />I1 <br />59021 <br />OU11-0 <br />22.00 <br />SRCHG <br />4.50 <br />TOTAL <br />46. 50 <br />ACKNOVJ!EDGEMEI OF COND!TLr*4EK 46,50 <br />The undersigned owneoapplicant h@@�Je�l•,3g s to hold and save harmless <br />the City of Everett from any and all claims'im•damages, costs, expenses, or <br />causes of action that may arise because of installation and maintenance of <br />the improvement or other right-of-way use hereto applied for and further agrees <br />to remove same upon notice from the City and to replace public property <br />danaged thereby. ) f <br />S gna ILre of Applicart Date <br />WORK AUTHORIZED BY TH S PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS ISSUED AND THLREAFTER IS TO BE DILIGENTLY PURSUED TO <br />COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />