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y c� t-+ <br />H. '� '7 <br />C-J C7 <br />Y �-3 <br />��N <br />�Hcn <br />r :� <br />H a3 <br />� z� <br />K O <br />H �1 <br />o xo <br />'sJ H'TJ <br />V1 H <br />t7 O [�f <br />�3 t7 <br />H C7 O <br />47 � :7 <br />H <br />ryz <br />Hy <br />O �N <br />G7 � Csl <br />HOV� <br />, <br />Date � ��Y��� <br />�pPliCaiion For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />M�iling <br />.tG✓ ,:� �/ _ <br />qpplicanl Mailin9 Address <br />cnv <br />City ZiP <br />-"�i..---'E- °`Z��i�L=—� ,r�:,�—�-,ci��•- <br />De;cribe Proposed Work <br />Projacl Address (�1 known) <br />FuhOcwo�haPeimit• _ <br />mau. ocou 9/ .a 7C 0 3 <br />ru��Icwo�kaFee $ <br />tclnl Foo <br />less Aoo� Foa PniJ $ <br />o.��anca ouo S <br />S�Lci 3a7—azi.� <br />A11ar.h loar �A) copies of plans for proposed vrork - Draw to scale and note Ihe lollowing as applicable: <br />• Proper�y Lines v Cen�edine ol sireet <br />• Outline and dimensions of al; enis�in9 and • Indicate Norlh <br />proposed strucWres on the lot • Show any proposed gmding changes <br />• Existing and proposed utilities • Shi�w meacuremenis <br />PERMIT CONDITIONS <br />t. All calls for insnection shall he made 2A hrs. in advance- phone 259•8810. <br />2. Pfl work �hall be peAormed in acwrdance wilh Ihis permit and currenl Gily of Everell Desic�n and Conslruclion <br />Standards and Specilicalions. <br />3. Ca�l Locatlon Underground Service 48 his. belore you di9. TOLL FREE NUM1IBER 1-800-424•5555. <br />l <br />v6- �.� C��n�f �'�,: -;«�- 2��t" �'-, ��_�,�.«<�' <br />r- <br />7J%nc�c�l�jv:.-�__ <br />sis� 9/ <br />Approved for Conslruclion D�dc <br />FINAL INSPECTION Dale <br />qpproved as Conslructed <br />everrt[ PUBUC WORKS DEPAI7TMENT <br />3200 Cedar Sircrst <br />�i Evcielt,WA90201 <br />�'I��oan: 25&0010 <br />� <br />O <br />a <br />ACI<NOWLEDGGMHNT OF CONDITIONS <br />The undersipned owner/applicanl hereby agrees to hold and save harm� <br />Icss �he City ol Evere�t Iwm any and all claims lor damages, cosis, <br />expenses, or causes of aclion Ihat may arise becau5e ol installalion <br />and maiNenance ol Ihe improvement or olher ri9hl�ol�way use hereio <br />applied lor and Iwlher agrees In remove same upon nol�ce Irom �he <br />City and lo ieplace P�iUlic pwperry damaged there6y. <br />s�y�,�w« oi nnnu�:,��i Dale <br />WORK AUTIIURIZED BY THIS PERMIT MUST BE STARTBD WITHIN <br />100 DAYS OF DAT[ PEiiMIT IS ISSUED AND TH[REAFTER IS TO <br />6E DILIGENTIY PURSUE� TO COMPLETION. THIS PERMIT MAY BE <br />CANC[LLEO �Y THf CITY UPON ANY STOPPAGE OF WORK O�V THIS <br />PIiOJf.CT OJ[fi 90 DA`!5 DUMTION. <br />