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. _ —�--------_.------ <br /> �.ce�-d (p ��KWo�.�.,,�,M. db''- �26 <br /> Applbetlon For eao.o.o�• <br /> PUBLIC WORKS PERMIT �°�W^�F� <br /> .a.i F« • <br /> , uu MµF«vra i <br /> Print or Type Only e.u�.ow t /Uo �'/y��.'� <br /> S�.uA,USo � / �// tl��,,_1iTf' Adc;, C�vL R�lf u1� - 9P'�'o/ <br /> Owner MaiNnp Address City Zip Phone <br /> F/a �1 c� n I s� ,�1 a oz/ � s' $aY�.� l I -uJ� h 8e K-ti�i/ ul.f_ �o � <br /> Ap cent Mailing Address City 2ip one <br /> DeacMbe ProPosed Work 4S�-�i�;IQ � N f e �y,� L(J A � �C i//fT_� itJ 'f'o <br /> i/ . / : i 1 l: v /�sJ1.4 : p: w 1 rG.. .� � ,'�,__r .i► ��t <br /> � �dc , - - W <br /> Pro�ect Addresa(if known) w � � <br /> Attach four(A)copiee of pl�ns for proposed work• Draw to acale and note the followinp as epplicable: � <br /> • Propsrry linea • CentnNine of street � <br /> • Outline�nd dimenelo�a of all existtng and • Indictle NOAh <br /> proposed etructures on the lot • Show any propoaed pradfnq chanqes <br /> R Ezistlnp and prop0eed utilitlea � • Show measuroments � <br /> DO NOT WRITE BEl W THIS LINE O <br /> PERMIT CONDITIONS <br /> 1. All calls for innpectlon ahell be made 24 hra fn advance•phone 2S9•881 S. � <br /> 2. All work eh�ll be pertormed In accordence with this permit end cur�ent Ciry of Everett Des pn and Conetruction <br /> Standerde�nd Specificatlona <br /> 3. Call Locetlon Unde!pround Service 48 hra befora you di9.TOLL FREE NUMSER 1•800�4a4•55aS. � <br /> �, !�/o,e.c- T ..s�E ��' �S'o .9s .vo7� O <br /> T JivTF�"�.eF Lc%TiY PFOc�sT,2iy.f/ T.�9R`iG� <br /> � <br /> � <br /> O <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersipned owneUepplicant hereby ayrees to hold and aeve harm- <br /> � less the City of Everett from any and all clalma for dam�pea coet� <br /> eKpenses, or ceusea oi action thet may a�iee beau�e of Imnllatlon <br /> C'��4�-`N �� //�0�� and maintenance of the improvement or other riyAbol•waY use heroto <br /> � 7 eppllad to� and further eg�e93 �O rR�nOv! lom9 upOn nOtICE fro�l ih! <br /> �Approved(or'Cone uctian ate City end to raplace public property damaBed the�eby. <br /> _-.i.�1'���as����o—�f G <br /> AL INSPECTION Date <br /> Approved as Conetructatl iq ture of ant Date <br /> PUBLIC WORKS DEPARTMENT W pK AU ORIZED BY THIS PERMIT MU3T BE STARTED WITMIN � <br /> e�erctt 180 DAYS OF DATE PERMIT IS IS9UED AND THEREAFTER IS TO <br /> � 3200 Cedar Street BE DILIOENTLV PURSUED TO COMPLETION.THI3 PERMIT MAY BE <br /> Eve�ett,WA 98201 CANCELLEO BY THE CITV UPON ANY STOPPAOE OF WORK ON TNIS � <br /> Phone:259•8815 ppWECT OVER 90 DAVS DURATION. <br />