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✓ <br /> r�-�3G S8—`��1� <br /> Date � _"•�`. Cl� v�oi�cwoasrc,mn,�� �'�_/�� � � � <br /> Applicalion For eio� oeo��+�(� /oC I 1 n <br /> I�UBLe� �1U��F(S PERMI T PuLTotal(eelee § _ <br /> LessAppl FeePeiO S �j - <br /> oaiance Due 5 `Q�p <br /> F'rint or Type Only -- <br /> � �,�� ,n�Ps lnn� � �a,�,����}'Y�i;1 l �� I �� <br /> wner M Ibng Adaress City i� Phone <br /> a��e� �.�- icri 1 <br /> AFPlicant Mai;ing Address i.ity Zip Phone <br /> Dcscribe Pr000seC Work _ -�1-1�.� l� ` I CJ � ��� LJ—L � ��� <br /> � <br /> — _ � <br /> Project Address(if known) �� � � � <br /> 0 <br /> Attach lour;4) copies of plans lor FroPosed work- Draw to scale and nc�e fhe following as appt cable: �� <br /> • Property Lines • Ccn�er'ine of street ♦� <br /> • Outl!ne and dimensions ol all eaisting anA A Intlicate North V� <br /> proposi�d structures nn�he lot • Show any propused grading changes <br /> ! Existim3 and proposed utilities • Show measurements ,�/� <br /> �li <br /> � � DO NOT WRITF. B�OW i HIS LINE � <br /> PERiUIT COND'�IONS <br /> 1.All calls tor i� spection shzll be made 24 hrs.in advance�phone 259•8870. ^ <br /> 2.All work shall be pedormed in accordance with this���eimit and co:rent Ciry ol Evere!t Design and Construction ♦ <br /> Standards and Specificalions. <br /> 3.Call Location Underground Service 48!vs.before y�u dig.TOLL FREE NUMBER 1-500•424-5555. � <br /> O?i���F�i _2�fD���t%�y �–�CWa� 'GEy,6��!�'/1,! tla'�• �.�–s'7.�/ .�F°� [^) <br /> �..PJ1i .YCa.qatC R.�.N 'a J'i�.% � ri�::+l.dt-eL(.0 /K�tll �-t/Gt,e,l`� �I <br /> rnv y/]"'c• _ �12•. f�–Y/'� � .Gz.`�Ln��2c� �'�307. �!'742�v�'Ta:G.^� <br /> nrwx�r�°� (a / sp�,E�( �L¢o�� Ceo..6 �e�"ueG•✓ /a2ute�..,Eu� � <br /> o ��-n� �i��c�-a'v , <br /> O <br /> � <br /> ,1CKNClVL�GG[M�NT OF CONDiTIONS <br /> Thr undeisipnud owner/apphc;rt hereby a9rees lo ho�d and save harm- <br /> �� I Icss tne C�ty nl Everetl Irom 3ny and all chirns for damages, costs, <br /> ` ��,J-� � expense;. or causes of actio,i thel may arise because of ins�allation <br /> �,� ,�:�> L ' / �� L7 /� �e �a and maintenance ol the ir:provement or other righPol�way use n�reto <br /> �U �y� applied for and furiher agrees to remove same upon notice hcm �he <br /> �Approved fo ns ructiory . / ���e Cit to r ice public oroperty damaged the�eby. <br /> i / <br /> �' S / �" //�/'` <br /> FINAL NSPECTION C ate " �-- <br /> ApGroved as Gonstructed Si re of Appiicant ���� <br /> i�veretl PUBLICWORKSDEPARI"MENT WORK AUTHORiZED BY THIS P[RMIT MUST 6E STARTED WITHIN <br /> 180 DAYS OF �ATE PERMIT IS ISSU[D AND THEREAFTEF7 IS TO <br /> � 3200CedarSireet BE DILIGENTLY PURSUED TO COMPLETION. T.HIS PERMIT MAY 5E <br /> Everelt,WA 98.01 CANCELLED BY THE GTY UPON ANY STOPP�IGE OF WORK ON THIS <br /> Phone:259�8810 PROJECT OVER 90 DAYS DURATiGN. <br /> ���:'��:i.. <br />