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-..� <br /> i <br /> y � �, � �` ` P�o�,�,vo,,,Pe,m,�. � 3D/ <br /> R ; Uate l` (i - _ <br /> r1 �„ eiaa o�o� • <br /> � � M . AppBcalion For c� <br /> � q �� P�iM�T Puni�cwo�hsPoe <br /> � � PUBLiC WORKS �o,r�F�e s <br /> � <br /> C� lessAouLFcePaiO S <br /> O � � � _.. p � BAanca Dua S `�S OD - <br /> "0 u~i N Print or Type On�y -: °' �' <br /> � «� � � <br /> ; ,,, <br /> � � � �-'"mP - �yJ �-�- ` ,� �-�. Jh <br /> ` ' � o A17-0P W� ��»d. _ . r� <br /> � � a �J �71 :o., �. <br /> Mailina ddr@�s �� u �� v, City Zip � Phone <br /> {{. r-. <br /> � A ��� QWn2! � I �Q I'1 �� O i. � _^� . <br /> � � � ' � ��' I �„P . ��cu�o n err(lrs� — �e r� W� 9i4�� r��lUB��% <br /> , <br /> q j ��mv — I� c � � c�Y z i n Pno�e --- <br /> qpplicant / 1 I <br /> � � � p y� �oc � p�I P 2 — �710 �t P U>� l�T <br /> l�i _ <br /> � Describer�rOpoSed Wurk � �OR�P R � � <br /> � � i --> „�,pd' '7 � 2,� �l7-P< C o�-. o ✓ __ <br /> i <br /> � W <br /> ' ° 1— <br /> v✓ ' , - MFk' ' <br /> iprojecl Atldress(il known) <br /> IAttach fow(4)copies ol plans br proposed work� Draw to scale and note the 1�' �wing as applicable: � <br /> I • Properry Lines • Ce.iterline ol strecl <br /> • Outline and dimensions ot all exisGng and • Indicate North <br /> I proposed slructures on the lot • Show any proposed grading changes <br /> • Existing and p�oposed utilities • Show measuremen�s M <br /> W <br /> j DO NOT WRITE BELOW THIS LINE - <br /> /r"_\ I O <br /> I ��� -�' PERMITCONDITIONS ^ <br /> I 7,qll C8115 for InSpeClion 5hall be mede 24 hrs.in advenCe-Phone 2$9•881U. <br /> 2.All work shall be pedormed in accordance with this permit and current City ol Everett Design end Consiruction ♦ � , <br /> ( ' Standards and Specificetio�s. � <br /> 3.Cal�Locat�on Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1•800�424•5555. <br /> � ,�_� � <br /> ' -/. �( / O <br /> �, � � � �yLs2� fo �e do�c �1e.✓ ��or� Q��i�v��/�n � <br /> j � � �.3'/-1c ,B� f�i�'' �✓6�.0 L�/ft O�c'�/. �CuP�/ G/7afiltd � <br /> I ��� I <br /> �� i S r!�.,� a�-o,fcn or �r��y�c� Si�t✓�L� $(a�l �e rep(Qcea� ♦/� <br /> �s ✓�-ccfec� 6y ����g�l.c /.var,(-.t ,Tnsp�cfor, Vr <br /> 1- � } � 0 <br /> �I �� I , wdr�E fv � do�2 �e/�Lann.n, ��1f IIA �raccsj !f c_�„ <br /> Ccnp.�ons. a <br /> `! '�1 1 . I 7' 7J�eP Ci�j Sf�ca�J ('�e,:,o nf 4ll �i.,,cs . <br /> I� ACKNOWLEOGEMENT OF CONDITIONS <br /> i <br /> The undersignetl owner/applicant hereUy agrees!o hold and save harm- <br /> •�� _ - -- Iess the Cily of Everetl from any and all claims for damages, costs, <br /> . <br /> }�1.. � —�� expenses, or wuses ol aclion that may arise because of installation <br /> ii� and maintanance ol lhe Improvement or other righ4ohway use hereto <br /> 3��� applied tor and further agrees lo remove same upon notice irom Ihe <br /> �i i-� — <br /> '�� Approvecy r Cons dction ���e City and ro replace puhlic pmPerty damaged therehy. <br /> ' - �,rJ��. _ rGU� g- L-4z . <br /> � <br /> � o,« <br /> I FINAL INSPECTION Slgnature ol Applicant Date <br /> I Approved as Conslr�cted <br /> WnRK AUTHORIZED BY THIS PERMIT MUST BE STAI7TED WITHI <br /> � PUBLICWORKSDEPARTMENT iB0 �AYS OF DATE PERMIT IS ISSUED AND THEREAFTEF IS TO <br /> I 320�Cedar Sheat B: DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Everet4 WA 98201 CANCEILED BY THE CITY UPON ANY STOPPAGE OF WORK ON 7HI5 <br /> � Phone:259•8810 PROJEC7 OVER 90 DAYS DURATION. _ __ <br /> ' __ _ _—____ _ _ _—__—__— — <br /> I <br />