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��� <br /> a � . <br /> ��� ..�, r <br /> Date 8��-92 v�oircwo�waae�mn• <br /> ��fl maa oeo� • 37642 <br /> � Applicalion For <br /> '� PUBLIC WORKS PERMIT Pum�cworb�eo s <br /> � iotelfee <br /> � Le»�Oo�Fe�PUC s <br /> Baience Duv S <br /> �� Print or Type Only <br /> p�a <br /> �y Christine A. Neal 1224 ll9th Dr SE Lk Stevens 98258 334-7856 wrk 259-6650 <br /> pw�e� Mailmg Address C�ty Zip Phone <br /> M <br /> N <br /> �M <br /> N <br /> � Applitanl Man�ng Atldres5 Ctly Lp Phone <br /> � Describe ProDosed Wo�k espieeso s[and <br /> Project Address(d known) Z400 H vitt AVf � I <br /> Altath IOw(41 COpiCS 0�P�anS�Or PrOPoSetl work-Draw�0 5[ale antl no�e Ihe 1011owmg as apph[able: � <br /> • Property Lines • Centedme ol streel � <br /> •Out6ne anC tlimens�o�s o�all eaisting antl • Indicate Nonh <br /> proposed structures on Ihe lot • Show any n�oposetl gradinq changes <br /> • ExiS�ing and propOSed u�ilAieS • S�ow mea5ur¢men�s � i <br /> DO NOT WRITE BELON'iHIS LINE O � <br /> � PERMIT CONDITIONS ' <br /> 1.All ulls tor inspection shall be made 24 hrs.in aCvance-phone ZS9-8810. � <br /> 2.All work ahall be peAormed in accordance w�Ih ihis permit and curtent Ciry ol Everett Des�gn and Construdion <br /> 1�/ StnndarOs and Soecdications. <br /> 3.Call Location UnderqrounC Semte 48 hrs.before you dig.TOLL FREE NUMBER 1•800�24•5555. � <br /> � <br /> '' O <br /> � P�G�t r��-- �'�-�f.(/�.f l��,.��u�' ,al�, �' <br /> � �/�� � � <br /> ►' O <br /> �'� <br /> - a <br /> ' ' FCNNO\YLEDG[MENT OF CONDITiON$ <br /> ' Tl,c untic�s�g�ed ox�evapp��canl hereby agrees lo hold and save ha�m� <br /> iess thc C��y ot Evereu trom any entl ail Uaims ior eamages, costs. <br /> ' e•penses, or causea ol acdon that may anse because ol mstaiia��on <br /> and maiMe�z�ce o� ihe improvement or other nghPobway use h�reto <br /> �;pbnh Ipr Bntl �wth��i a9��rs b remove same upo� nol�ce �•om ihe <br /> Approved for Conslructlon Dale ��iy,�n�f tc�r.•n�,�ce nub�ir,o�oc�'rty damaged Inereby <br /> FINALINSP[CTION Date _— <br /> FpprOve�a5 Con6iruc�0d tir�n;�l��c CI Appb[ant n��� <br /> PUBLICN�ORKSDEPARTIdENT 570Rk FUiHORRED BV 1NIS P[F�diT tdUST BE STARTED WIiHIN <br /> 1B0 DFVS OF DATE PERMIT IS ISSUE� AND THEREAFTER IS TO <br /> J200CetlarStreel BE DILIGENiLV PURSUED TO COMPLETION Tr115 PERIAIT MAY BE <br /> Evereil WA 9820� CANCELLED 8�THE CiTV UPON ANY STOPPAGE OFIYORK ON THIS <br /> Phone:259�8810 pqp,l[CT OVE�+!0 DH'/5 DURATION <br /> � <br />