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__,_�,....____. -�-•_--- - .... Y____. _ .. . _ .,_.. . - . - ,.«� - <br /> ... . �:.....r-- _.�.:..�r.... -- . .yM'�y.� T '{ <br /> � <br /> pa�@ yl � . Pupec Works Permn� � <br /> Appllcetlon For eiae oso��•_.� ' � <br /> PUBLIC WORKS PERMIT P�eTON'oFbFee f <br /> Leaa Aoo�Fee P�iE s <br /> Print or Type Oniy Btlence Due f <br /> -Tn�) c.l �,�.i.;�r�Lcr t5s..�.u.4�u� '�r�.I��ZQ/ r�q-�,�s ti '- <br /> Owner MeiNng Address City Zip phone <br /> �Gi M'_ <br /> Applicant Mailing Address City Zip Phone <br /> 7 1, ('� <br /> Desc:nbe ProOosed Work �;N�Yl f G'1.1� C,I� , f L�., � ����.�: . <br /> W <br /> �Iect Adtlress 1il known) �� � <br /> Attach lour(4)copies ol plans for proposetl work• Drew to scale and note the following as applicabie: � <br /> • Property Lines � Centerline of street � <br /> • Outline and dimensions of all existing and • Indicate Norih <br /> proposed structures on the lot • Show any proposed grading changes <br /> • ExiSting and proposed utilities • Show measurements <br /> • DO NOT WRITF BELOW THIS LINE <br /> � PERMITCONDITIONS O � <br /> 1.All calls for inspection shall be made 24 hrs.in advance•phone 259•8810. � <br /> 2.All work shall be peAormed in accordance with this permit and current City of Everett Oesign and Construction <br /> Stenderds and Specificat(ons. <br /> 3.Cell Locetion Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1•800�424-5555. � <br /> /'�j��'�/��i"i�:ij.:.j�� ..�;%/'�/�J O <br /> ! <br /> r <br /> �/�f-L/l��'/T //r c- .. , . ._� � ...- . - .'-C �. !i<:� ;.. ._ _ . � <br /> O <br /> a <br /> ACKNObYLE�GEMENT OF CONDITIONS <br /> The undersi�ned owner/applioart hereby agrees to hold and save harm• <br /> less the Cily ol Everett Irom eny and all claims lor damages, costs. <br /> expenses, or causes of ac�ion ihat may arise because ol installation <br /> and maintenance ol lhe Improvement or other right�ol-way use hereto <br /> Approved for Consiruction Date aPPlied lor and lurther agrees to remove same upon notice Irom the <br /> City and to replace public property damaged there6y. <br /> FINAL INSPECTION Date <br /> Approved as Constructed Sigoature ol Applicant Date <br /> everett PUBIICWORKSDEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITH�N � <br /> 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> � 3200CedarStreet BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Everell,WA 98201 CANCELLED BY THE CITY UPON ANV STOPPAGE OF WORK ON THIS <br /> Phone:259�8810 PROJECT OVER 90 DAYS D'JRATION. <br />