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Date s-`�-9y�. 9'f� /65� i <br /> �•��.,. ��o.«�P,m�. <br /> AOpliCa�ion For � e�nq �e�� . _ ._ <br /> U? <br /> PUBLIC WORKS PERMIT �. P���,��=,v���sF�� ---- <br /> « ,o�a��o� s <br /> 0 <br /> G lexs anui ro..aa�i S_ <br /> o •lOpO <br /> Print or Type Only � $ g eT�.,���r,,,,� s <br /> N o0 <br /> � «+ :� GbZ-.32Z5<o/783/ <br /> / � <br /> C1MnC� 1l�30 �luaCo FJ, ED.yoyDS� 980,�0 (,�p- 76�/ <br /> Ownei A^�a�:n,�, 4.:urrss �.:❑ � �� `� 7m Phone <br /> � { 1- W <br /> `�L6�StEiL � Sv�l C'oNs-� 12�303 Cye,��s Wv �3M�i��o q6d�s ly-� � �+9�1� <br /> �— ---- <br /> APPlicant M1^.,�6�, dddre,s __— _r-.�t�: _- .---��o _______ Phnna ___. <br /> Describe Proposrd Work _�EMo�At_ OF._J1_�u�Ea_ F71�.pun�_�_TJtn11�,_ APP(r�,e _��0.� C��s, <br /> --- --- __ _--- -- ----- ----- — <br /> ------ 7�lOz._I�e.w!N_i4Yt.-- ----_ -- --- --- W <br /> ProlectAddressldknown` S.� _ CO�n1EIL_QF_.._�EW.Rr C_�1Z00.DWky---_— � <br /> Attaeh four 141 eoP�es ol Vlnns fo� ProPosed�ti��>�.. D�av. ro �rm.. .�-a ccie P��• :onnvnnq as nnobrnh�e � <br /> • Pronerty Lines • C�•of"•Imn „! s;re�.t � <br /> • Outline and dimensions of all exi5;mr,an,l • I�rLcoP+, No��h <br /> praPosetl s�ruC�ureS on the lot • c��p�y,y���, -rnnesrd qi:iNinn rl;an�rs <br /> • Eristina and Proposed u�ihfies • Shnw mn�3ii.pir�en�❑ .. . � <br /> DO NOT WRITE 6EI.OVt' iHIS L W E O <br /> PERMIT CONDITIONS <br /> t.All calls for inspection shall be made 2a hrs.in advance•phone 259•8810. � <br /> 2.All work sha;l be performed in acwrdance with this permit and current City ol Everett Design and Construction <br /> Standards and Specifiwtions. <br /> 3.Call Location Underground Serv�ce 48 hrs.before you Aig.TOLL FREE NUMBER 1-800•424•5555. � <br /> T, /�.1�' G�' S-�'�.�c`�' G�Ga"' af a�C ?�iincs. O <br /> ✓`. .1-ric �` 6ctn.c Gat�Qi.. �c h�r' '�i n c r i� �o f7�'e V e"+ -/ � <br /> PL�� S7�Y4��S OY V�C���LcS �i�c�� ENTEQ/N� (i.JOR� � <br /> ,��a, O <br /> a <br /> �•CKtvOC;LECGCCIEN* OF CONDITIONS <br /> �. . ,. , . :n�,.i a�:n���.anniicant ni�iebY a9rees to hold antl snve harnr <br /> — ---- ---- ----.— .. —. . . . �. ... :I�,e Cdy r+ f_ve�etl lrom any anA all claims lor damageti. costs <br /> � �-v�rns�s. or rai�yes ol aclior. tha� may aris� because Of i�,s�allation <br /> nnd main�nnanr.e ,�r ihn improvemeni or other npht�o��waY U5P here�o <br /> � ��� . � a^n��c�; inr and h,riher aqrees to remove same upon nolice Irom the <br /> ApProved for Constr c io� --D�dn � �.y��;:;1 m�..nlaca r.uUb� ProneitY damageA therebY. <br /> �" <br /> .� � S•.r_°-�j� ' �i+�.� �'�►-�•i.�. `f <br /> FINFL IN;�pECTION T p��n <br /> i I.c� L .� 5-"E- 9 <br /> Approvetl as Constructed i Sicuialwe ol Applicant Date <br /> ���_' PUBLICV�'ORKSDEPARTMENT WORV( AUiH�=1R12ED 91' TNIS P[RMIT MUST BE STARTED WITHIN <br /> ��E.� 3200CetlarStreet ' tH0 D�YS G' DATE PERAtIT IS ISSUFD AND THEREAFTER IS TO <br /> Everett.WA 98201 3E DiL�GFWTLY PURSUED TO COMPL[TION. TNIS PERMIT MAY BE <br /> Phone:259-8810 �-•1"�CE L L�D Bv TfiF CITV UPON AN1'STOPPAGE OF WGRK ON THIS <br /> PROJCC 1 OVER 90 DAvS DURAiION <br />