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� <br />�� <br />I.� <br />PUBLIC WORKS PE`�iM�T <br />TYPE OR PRINT ONLY <br />sa� <br />l'.�?.TiI:'7• .. . ..,:..�'d.:Ti3 <br />Pueuc wams oewwn�ear'�: <br />3zoo ceee� s�e ' �1 <br />Everett. WA 98201 258-8810 �*' <br />r: <br />�K <br />T, <br />PRWECT ADDRES/S pf known) 2� � <br />� <br />�, `0 22 rJ�l <br />�,�,b �,„. 98 � � <br />BuNdqq Pxmit N <br />Pudk Worka Fee S�� T� � <br />�&x l8� �1��' �,� r.✓�9Pzz3 ��irzz <br />�� � � <br />�F �,k a� s� � u� <br />� �. : <br />z� <br />Attech four (4) copbs o} plens tor proposed work - Drew to ,cale and rate ths folbwing H applkabls: <br />'Property Unes 'Outline and dimenslons of ell exi;ting end proposed ahuctwss on the bt 4xlatinp and qaposed udlkfss <br />`Centerline ot street �ndlrate North 'Show enY proposed qradkp ehrqes 5how rt�suremenh <br />PERMIT CONDITIONS: <br />1. All calls for inspection shall be made 24 hours in advence - phone 259-8810. <br />2. All work shall be perfortned fn accordance wkh this pertnit and current City of Everett Design and <br />Construction Standards and SpeciBcations. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-42�M6666. <br />4. J�P.,ep C/�j' S�^�S C�aah 41� .ell r,ine! <br />ACKNONM1EOOEMENT OF CONDITIONS <br />Ths �x�dersfpned ownar/appbant hs�aby proes to tald end save hemdess <br />tAo Clly of Everetl from any and aN c1�Nm for dem�pes, cosla, expenass. or <br />� a aaw� me� may � beca�,.s a x,s�exeew� a�w mdmsn� m <br />u,e �mpoverw,� «onier 1qm-ot-way ue.lws�o ep�lbd raand nxai« apees <br />to rertave wne upon ratice hom the CMy �nd to replace pubHc propeAy <br />damaped the�eby. <br />� � �/L��� <br />Siqneture of Appllcant D�M <br />WORK AUTHORIZED BY THIS PERMR MUST BE STARTED NAIHIN 180 DAYS OF DATE PERMR IS ISSUED AND T}1EREAFfER IS TO BE DILIOENTLY PURSUED TO <br />COMPLEfION. THIS PERMIT MAY BE CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS PRQIECT OVER 90 QAYS DUM710N. <br />