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Appkabon For <br />PUBLIC WORKS PERMIT <br />PUBLIC WORKS DEPAR%4ENT� r <br />3200 Cedar sheet <br />Everett. WA 90201 2"10,'. <br />TYPE OR PRINT ONLY <br />BuMdNp Per" a <br />PuLAc WoFee fi Z0 �� <br />ks <br />?AyL_(n6,w,EL au(* t4iGN Jj— EvEr&rT w4geoiw (W)s ems` <br />Owner Mal" Address City ZIP Phoft <br />SAME 4C A60vet <br />Applicant Mailing Address _ city ZIP Phone tt- <br />Describe Proposed work PUT A flRtVE WAY eMn2RA/cr= FOR SmuN Sf0. ul <br />�1 <br />PROJECT ADDRESS (if known) 64 a M <br />Attach tour (4) copies of pans for proposed work - Draw to scale and note the following d applicads: <br />'Property Unes e0utllne and dknensions of as exlstkug and proposed stnrchasa on the lot mExistkq and proposed ulWhee O <br />mCenterlke of street 9ndkate North 'Show any proposed grading changes 'Show measurements M2 <br />PERMIT CONDITIONS: Z <br />1. All calls for inspection shall be made 24 hours In advance - phone 259-8810. O <br />2. All work shall be perfomfed in accordance with this permit and curenl: City of Everett Design and <br />Construction Standards and Specifications. <br />3. Cell Location Underground Service 48 hrs. before you dig. TOLL <br />LFREE HUIIASER 14100424.5551L <br />At�N/� <br />Rii� orris,pwo�/ S(o�Ie q�{�.r �CQf 4rta. Dttiind YI <br />S�✓✓W r,of Jf&a 14 -m� 60-ce ZVOj)WrV,&A O <br />�ae dA+etwi� 6sLow, a <br />S Exis>F.:3 cortcee*.Sr "a h A"Vj/ 6e A-irno✓eol <br />�"ePCaced svrfl�"(o'��i•ck coylc�+r>E duivewwj/ tafrotla[.� <br />of Wrtc4oi bye ci,<y public rrt7r�Es irtt�oeaia,r, <br />T..rir.t Ittljtn�vrA. <br />kt�k D�e•kf IsIT► <br />Strc..� S G �P�opotbD DRrV/lWA <br />CROSS-SOrcTton! OF STA <br />EET <br />ACKNOWLEDGEMENT OF 00NDffVM <br />The urdlaaigned ownrwtopplicard haft apsaa to hold and save haimbas <br />in Guy of Everettt ham any and d dO fa drrryaa, sow. wowm , Or <br />classes of adlorl Mat may arW because of' and makdwwea at <br />tM krfl mmlam orosrla dplM•cf-way uehlaeb IPPW forladAAssrmesa <br />to m"m ears upon moll,ham eta Oty and to repMoa Public praplaly <br />daybed asaeby. <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED W"MN 100 DAYS OF DALE PEl" 1818 M AND THOWAFTER IBM BE DLX MLY RIIBIIED TO <br />COMPL.'T10N. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY 811OPfMAE OF WON( ON THIS PRDAW GIM 0 Will0U1Y01011. <br />