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Date _ u IS � lS � U LS D �,,> -;- ,;.-..� ._ �'5���__�
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<br /> FppfiCanon Far ':�� '�`c' —
<br /> PUBLIC 1NQRKS P � III��' 1 `� 1995 �,,,,,�v,o,.,�,.� — �—
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<br /> CITY OF EVERET'L --aso-- —
<br /> Print or Type Oniy 81dg. Permit Counc� ea���-�o�, s__��=___
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<br /> Ownei iVaGin�.�4}�d��5. 's :. Gt., _. �
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<br /> AppI�C2nt "dv�ln�q Adtlr.,ss City ZiP Phona -.- . . . _
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<br /> Describe Propos� VJork C 1�0 L�L� l 4J O ��� ������ti� S ,-lL�(_�i � f-L_�,� (�-:
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<br /> ) A[Sa j�vSTnCL C✓LIi�T F2o� - ■ . ■
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<br /> ProiectAda��ssl�l knownl ���<—��/�_� � �. � W_�/_ .// --�L E" __ . . �_c� � L- � ��/vEG�q` ' � �
<br /> Attach fow 14) coo�es ot Plans lo� uroPosed worv . ��a�: �.. .. .,.... �,,.... .i��. �d�;�a��ng ao.�:,i�iu.�:.��. �s
<br /> • ProPe�'� l.inev ! C,;c�+�rline of SVe��± �
<br /> • Ou;Onn ,�nd dimensi0�s ot all existinq and • �^r!�--;±t4 >lnrih ���
<br /> prOPosetl slruclure5 on�he Int • �".���„ ,�ny r.;c;�o;Nrt ,;i,3r.�nn rhanao-s
<br /> • ExiS�iriQ and propOSed U�ilihe5 • Sh�i;i rnr�asuremr_ni;; �
<br /> UO NOT VJFIIE 5E:_OVd THIS LINE �
<br /> PERMIT CONDITIONS i
<br /> 1.All calls for inspection shall be made 24 hrs.in advance-phone 25J-8810. ' �
<br /> 2 All work shall be pertormed in accordance with this permit and current City of Evere�t Design and Conslruction
<br /> Standards�,�nd Specilications.
<br /> 3.Call Loca:��on UndergrnunA Service 48 hrs.before you diq TOLt.FREE NUMBER 1•800•424•5555. �
<br /> 4, � ItST. I� .'1D l..f, d� /.�ii R,(�.5 , S �'o�-t., lJa � �
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<br /> �, R �� h� �tw�,� w; �k%� th� t-� ��,-� o�- w �y� VJ
<br /> 0
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<br /> j ACKNOCJLEDGCCIENT OF CONDITIONa
<br /> `l7� �� _����S�y��� _ ��5� l hr�:inqp��iqned owi�eUdPUhCant hcreby a9ree5�0 hol;l:inC s.r.�,h4inn-
<br /> � � �
<br /> - Irs° 'he City of Everetl Irom any and 211 claims lor clain.,�u ��,isls
<br /> / / r.pe�nses. or causes of ar.tion that may ans� because ol ins�ill�tirn�
<br /> _----41;y�� � / _ �O ��> .nd rniinten�nce n� the improvement or �ihei ri9ht o��waY us�� h aebz
<br /> ���� -�-�.t� nd lor �nd furth�r aqrees to remove samn upon notice f nm Ih�
<br /> Ap,roved for Construchon f` ,�. ,.��,��������-placa uubhc pron�'ny dama9ed thereby
<br /> 'i" '�'_- 7 lf� / C � � �� ��
<br /> FINAL INSPECTION Da�c �
<br /> Approved as Constructed � i S�qp.turn_ ol Apphcah! Date
<br /> �A��e� PUBLICWORKSDEPARTMENT !YORK AUTHORIZED�B T {IS PERMIT MUST BE STARTED WITHIN
<br /> 3200CetlarStreet �90 DHYS OF DATE MIT IS ISSUED AND THEREAFTER IS TO
<br /> Everett,WA98207 I dE DILIGENTLY PURSUED TO GOMPL[TION. THIS PERMIT P,tAY BF
<br /> Fhone:259�8810 �, �����1�ELLED H'i TH[CIT'f UPGN AN1'STOPPAG[ OF VJORK pN Tf{IS
<br /> PRp.IEGI OV'tR 90 D.1'r5 DUFI�TION.
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