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Cx�1Cr'.1 � G:� ' :��'�' " �� <br /> Q`.0 "�� Date.�LY=9ly v„�v��w�,wsv..�::,�� $� -- <br /> C. rr �;��,� �..�, . ���a�G i---�-� <br /> � �xy PtJBL,I� Wpf7�RKS PCRMIT - ---- -- -- <br /> �"� y� f'��IilicW014Sf�•r. <br /> �i � to�ql FCn i_ <br /> f] � �ess>noi Fec C:nu $---___ <br /> � �p� dIX <br /> �H 'i7 T... �^rT��Ir I/='-I--L__ o,ia��.�n�.: S �C' _—_ <br /> y p� � Print or Type nnly �� — <br /> [�i O i� <br /> o�1 H g �r r� t{- ,�r �l�5 Pl�r� 1�� i;F�' 9cP03 6 ��Fr-i�oD �c� 3S� 9���:�_ <br /> H M Owner M�iling�tldress Ctly 2ip Phone <br /> G]� f� <br /> M � <br /> L�y 'L �aqpp�� Mailing Address Gity Zip Phone <br /> �HH n <br /> d y Descrihe ProposeC Work �?ielL�__k�i,�._Sl1�.QI�'�.-{���I�p Laf B .S� ��U-J il __ <br /> �� � � " -- <br /> HO [yn — � <br /> 1 ( ' ���� q � <br /> ProiectAddresslif knowN a� Z E•1Y17PfC(�V _�-7v c- -_ <br /> ! <br /> Attach four�4)copies of plans for proposed work- Draw�lo s'c.ile antl note Ihe loll�,ving as applirable'. o ' <br /> • Property Lines Y Genterline ef slree� /^ <br /> • Oulline :�rd dimensions oi all exislin9 �nd • Indiaite Norih V� <br /> proposetl sirucNres on ihe lol • Shov. any proposed grading changes <br /> • Exisimq ,.nd pr000sed uUidies • Show measurc-nenis M <br /> rri <br /> �'1�1 DO NOT WRITF_ BELOW THIS LWE o <br /> �'� PERMIT CONDIiIONS <br /> � 1.Atl calis for inspection shall be made 24 hrs.in advance�phone 259•8810. � <br /> I2.All work shall be performed in acco�dance with this permit and current Ciry of EvereC Design and Construction <br /> .�` Standards and Speci(ications. <br /> . == 3.Call Loca�ion Under9round Service 48 hrs.before you dig.TOLL FRGE NUMBER 1•S00•4'G4•5555. �y <br /> G <br /> � <br /> � i'o i � <br /> � <br /> s�.��� � <br /> O <br /> �y � <br /> c..y <br /> II C�� ACIWOWLE�G[MENTOFCONDITIONS <br />� �� �, 1'he undersi9ned owneUapplican�hereby agrees to hold and save harm- <br /> ` ��l,. ---- Icss ihe Cily ol Evereti irom any ard all claims for dama9e�s. co5i5. <br /> expenses. a causes ol oclion lhat may arise Uecause ol ins�allation <br /> 1 v �� and mamtenance o� the unprovement or other righbof-way uso hereto <br /> ,�� I��l`�C L, � 1 �� � applied for and luriher agrees to remove same upon nolice iwm Ihe <br /> Aporove or Conc�ruclion ����' Cit d Io replace public property damaged there6y. <br /> ,�• � � � <br /> i <br /> � � �` > : �� !� i��;��/�� _ ���� r ,+.� /[���6�-8/� �i <br /> FII.AL WSPECTIOIY - Datc <br /> AGPrcved�s Cons�ru��ed Si9nature ol APP�E�nt D.+Ie I, <br /> WORK AUTHORIZED BY TNIS PERMIT MUST BE STARTED WITHW � <br /> everett PUDLIC'�'GR:'.:.`EPAR7MFNT 1B0 DAVS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200CedarStreel BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br /> � Everett,VJA 9G201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> '�p phrne:259-B810 pqOJECT OVER 90 DAVS DURATION. <br />