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��� � >,— <br /> cp r�nncwo��sPwm:(��q _'J'�.�r- <br /> CBIC'�D��_� I ni:,p o.�ci . — d1_��GC.1'W5 <br /> FnPlicaticn For <br /> � PUBLIC Wt��RK� f'ERMIT ������"""�„'�°` � — <br /> ,�„�FP� S- <br /> x C'7 — <br /> C�1 L�] �,.-,now F��vn,a 5 � - <br /> 9H o��rn�:�ou�, 5 Z�'— _ <br /> ay� PrintorTypeOnly �� p������y / '7 ' �� �� <br /> H 93 <br /> " y� l�c. Il�� ., -tf' � l'f35 /.=I.N ��� l���inr S�D36 ^'��`-��00 �r355=�S5b <br /> � �p �..����� Mailmy Atltlress City Zio Phone <br /> �H <br /> y 23 S � - -- --�-- <br /> � y d Applicant Pdadin9 Adtlres; Ci�y Zi? Phonc <br /> I� � I, d� �,tl (,�r�� <br /> � �� Desr,nhe Proposed Wcrk ��U� C!{'�G�P fR � � ..�J - <br /> L]. nq <br /> 9 H[�7 -- <br /> CHy �Cp G� <br /> H <br /> � ov, �-�I� C. lN'R)�.�il'�I ,1�C' ',... <br /> � �� Pro�ecl Address Id hnOwn� - -- <br /> �� <br /> Z H L9 latod,tour iAI copies ol plans for proposetl v�orh� Dra�:� io s::.�in��ntl no�e ine;o'lowing as aPPlicable � <br /> '� �� • Propeny Lines • Centerline ol sireel <br /> • Outlme nnd Jimersions o� �+li e.�sPnq ;:ntl • Indmale North <br /> proposetl s�rueiurCs on Inc Ici • Show any proGosed 9raAin�� chan9cs <br /> • Exisling and proposed ubl�bes • Sho�v measuremen�s � <br /> ����� <br /> CO �JO7lVHITF EELO�• THIS LWC q <br /> I 1 <br /> PEFId1T CONOITIONS `�� <br /> '� am. 1.All cads lor in;pection shall be made 2a hrs.in advance-n��<;cs 259'88�0. �1 <br /> � 2.Ali vrork shail be pedormed in accadance vrlth thrs nermit i�nn o,uent Giry ol E��erelt�esign a�d ConsVuc:�on ii <br /> , .niv. <br /> Slandnrds ar,d SPecilications. <br /> 3-Gall Lnca:ion Undc�ground Service 4R hrs J��foir you d�:� TOLL FREE NUMBER 1-$00-424•5555. � <br /> !- ,i �M� <br /> .._ .' �s <br /> � <br /> - � � <br /> � <br /> � � <br /> v <br /> ' � �..�� ,�(;FfY)V1lEDGLL11=HiD6CGNDITIONS <br /> � '^-`" � The untl�3rsi9ned owner/apUhsnnt hcroby agrees to holtl�rd snve hurnr <br /> ��/ less the Cdy of Eieiett Irorn ony and all claims lor Uamages, costs. <br /> eznenses. or causes of ar,hon that may arise because ol instalLriion <br /> �� � �^n �, I�R �� 1 .,•�1��I and ma�i��enance of ihe �i��Crovemenl oi nther ri9h4obway use hereto <br /> '-t' �� " l � � applied lo� and Iuriher agrees to remove same upon nolice Irom Ihe <br /> Approved Const�ruc ion �ale Q�y and to repi�ce pubhc property dama�ed �hereby. <br /> j���l%s������� /��`t �p/ �l� -z' 8n <br /> fIIVAL INSPEC�IOId '/O 1 0'� <br /> �nnmved[is Cnns�rucled Si9nature ol Apphcant <br /> WORK AUTHORIZED BY THIS PeNM1T MUST BE ST�RTED WITHIN <br /> rw�rri: �UBLICWORKSDEPARTMEN! 180 DAYS OF DATE PGRMIT IS �SSUE� AND THFREAFTER IS TO <br /> � 3200CedarStreet BE DILIGFN7LY PURSUED TO GOMPL[TION. THIS PERMIT M11AV Bf <br /> Evurelt.WA 98201 CANCEI.LL'D i�Y TI-�E CITY UPON ANV S10PPAG[OF N'ORK GN THIS <br /> Phnne�.25�3�861C �� pqOJECi OVGH`�U DAYS DUfi,1TION <br /> J i <br />