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44 <br /> R. <br /> + 1 <br /> � ♦ . . . .a F ' . . ..'�J {'� <br /> � � '� <br /> a � ��„�..P.,�,�. ��'l� <br /> t'�-•17�� BMY.D�ot• . <br /> Applkatlon For <br /> PUBLIC WORKS PERMIT °°°'�"""""" �'t <br /> ;Y taur« � <br /> ���ppl Fw MA s -- <br /> e.i.��.o�,. t �d� <br /> Print or Type Only <br /> iinwin f]��ePMFJJ'C 113q 34�' n+� SF1l7sl-�= �►8122 321.�-306D <br /> ��� M�INnp Addrens Clty 2�p Phone <br /> .e�.__..�., ��� 5�— <br /> Applkant M�Ilinq Addreas City Zip Phone <br /> D«crfbs ProM�sd Work r�ui.�w ZI,L�it1� F C�i� <br /> � W <br /> PrW�clAddros�plknow�) ��O$ NtA.UI� � <br /> Ad�ch four(4)copb�d pl�n�for propaeed work•Dnw to acale and note the tollowinQ as applicable: � <br /> � Propsrty Llnes • Centerllne of street � � <br /> •Outlins�nd dimanalona ol all ezfstinp and • Indicete North <br /> propoeed�tructuroe on tha lot • Show any proposed grading changes <br /> � • Exietinp�nd Dropo�ed utllftbe • Show meesurements � <br /> DO NOT WRI BEIOW TMI LINE O <br /> PERMIT CONDITIONS <br /> 1. M�uus for�n�psct�on ahe��be mede 2a nrs In advance•phone 2S9•8815. � <br /> 2. All work shNl be parformed in accordence with this permit and current City of Everett Design end Conatruction <br /> Stmd��d��nd Sp�ciHc�tions � <br /> � 3. C�II Locdlon Und�rpround Service 48 hra.before you tliQ.TOLL FREE NUMBER 1•B00-424•3355. <br /> '/ � �/�j/ S�/�/Q�ie�GT/v/V � F <br /> 7 F/.�c0 i�+,c5'��T�'- O <br /> � � <br /> � � <br /> ; O <br /> � a <br /> � <br /> D2/OS/87 1�59FM OOORM3934 �� <br /> � ACKNOWLED CONDITIONS <br /> ' The underoigned owner/aDP��a�Y e��hold and aave harm- <br /> less the Cfry ot Evaretl irom eny entl all cl�ima for damepa0. coet0. <br /> ezpensea, or ceusea of action thet may ariee becauae of Inatsll�tlon <br /> � - and maintenence ol the improvement or othar right•ot-way uee heroto <br /> a epplied for end lurther egrees to remove seme upon notice trom tha <br /> i � d tor C ructi � te Ciry antl to replece public property dameped thercty. <br /> �- .��/���j / !/�-�"�� �_S-�'•7 <br /> � FI SPECTION Date D te <br /> � ApprovM es Conetructed tu ot Apvlicent <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> ��� PUBLIC WORKS DEPARTMENT 780 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> � 3200 Cedar Streel BE DILIGENTLY PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Everett,WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phona: 259•8815 pROJECT OVER 90 DAYS DURATION. <br />