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( <br /> Date-9l]-9/-90 r.oi��we,,.re�.,�,. <br /> APDticalion Po� ere�Deo�..�f1�2$F49 <br /> PUBLIC WORKS PERMIT ^°°;o:,:�•° : <br /> teu�oo��.v�m S <br /> Print or Type Only TO POSTING��...`� o,�.��.o�. s <br /> William Gazdner 7518 Heather Way EVezett 98203 353-34d5 <br /> Ownor Mailinyqtl0,ess Cily Zip Pnonn <br /> Owner <br /> /OOlicanl MailingAtlEress Gly Zip P�one <br /> DescriJe Proposetl Work Ney�draqn at aFR ___ <br /> W <br /> Prajec�Addresspf known� � <br /> Allach lour(4�copies ol plans loe proposed wo�k�Draw to scale and note Ihe I011owin0 as appllwble'. � <br /> •Properry Lines •Centedine al slreet /A <br /> •Oulline anC Cimensi>ns ol all esistino and •Intl�wle North r� <br /> P�o�osetl slmcW�es On I�e lot •Show any proposed g�atlmg changes <br /> •Eeisling anA orooasud Wdiiies •Show measuremenis Y <br /> W <br /> 00 NOT WRITE BELOW THIS LINE O <br /> PERMIT CONDITION:I <br /> 1.All calls br inspeclion s�all bo made T4 hrs.in ativance�phone 259•8810. � <br /> 2.All work shall be OeAormetl in accorEance wi�h ihis permit and current City ol Evereti Design antl Conslmclion <br /> Stan0arE5 anC SpM:ifications. <br /> 9.Call Lxation UnderBmunG Servite 48 hrs belore you Cig.TOLL FPEE NIIMBEP 1•800•424•5555. I� <br /> L <br /> /� � <br /> �J' !'tJ6�ic Luor,Fs �rm.f �'pU�/'eo� N <br /> D <br /> ���� N <br /> /o-z3-90 O <br /> a <br /> ACKNOWLEDGEMENT CF CONOITIONS <br /> T�e untle�s�qncd owner/apPl¢anl nereby aqrces�o hoitl aro]save harm� <br /> -- less Ihe Gry of Everetl bom any antl all cla�ms br dartia9es. cosis. <br /> e.penses, or causes ol action Inat may a�ise brtcause oi instailallon <br /> anE mninlenanc.e oi Ine imprwemeN Or oth¢r nphPOFway use hurelo <br /> apP�ied lor nnE Iuri�e�agrees�o�emove 52me upon not¢e Irom��e <br /> Appmved lor Cou5lmcli0n Doio Ci�y antl IO�eplacC pubhc propC�IY tlamagetl I�ereby. <br /> FINAL INSPECTION � Da1e <br /> Ap�mved as Conslmcted Signatwe ol ApP��wnl Date <br /> cur�rll PUBLIC WORKSUEPARTMENT WORK AUTHURIZED BV THIS PERMIT MUST PE uTARiED IYITMIN <br /> � 3200CetlarSheei 1B0 DAVS OF DATE PERMIT IS ISSUED AND THEREAfTER IS TO <br /> Everett WA9B201 BE DIIIGENiLY PUFSUEO TO LOMPL[TION.THIS PERMIT MAY BE <br /> Pnonn:259�eB10 CANCELLED BV TME CIIY UAON ANY STOPPAGE OF WORK ON TMIS <br /> PPOJECT OVER 90 DAVS DURATION. <br />