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, <br /> � _— <br /> B /9-�9 -s <br /> DateZ.�R_90 ������w�,.,P�,m,�. �` G- _ii 5`'J <br /> ApPlica�ion For <br /> TO POSTI N G__ ��—z s�_a , e,a9 o�P, . _ <br /> ��� PUBLIC WORKS PERMIT r�eTowmP`ree s_ <br /> Q lesa Aoo��ee Fina s�— <br /> y �� Print or Type Only B•�•^�^o�� s ���— <br /> �a�� ✓q i�e� .S'oi-�4�,0 /9.�"��- c�i-rr�ci lJ.c- Eo�1.' 9d'O/ 2S2- OS75' <br /> � Owner Mai�ing Address City ZiP Phone <br /> � Q� s4IhE�'. — <br /> O N App caN MaiGnq Address City Zip Phone <br /> li <br /> �� Descri6e Proposed Work C�hv�'�'� SF'�'• �O !�!/��C�' <br /> �i y — - <br /> N <br /> �� 09/24/90 4�25PIf OOORM3B19 � <br /> ��q Project Address lil known) ��T� - G'�*�'��"�L � � <br /> 60 BLUO f349.50 <br /> a Attach lour(4)copie5 0l plans lor proposeA work�Draw to scale antl no�e Ihe lollowing as applicable: �� �.� � <br /> � • ProPerty Lmes • Centedme ol street � <br /> • Outline nnd dimensions of all existin9 and • Indicate Noith �� �•� <br /> proposed sVuctures on the lot • Show any proposed gradiFi�kl�Nges�iZl.� <br /> • Existing and proposed utihties • Shew measurements B � ��� � <br /> DO NOT WRITE BELOW TNIS LINE N�1I1•�39 O <br /> 1; C' PERMITCONDITIONS 1I71-S f3�.40 <br /> � 1.All calls lor inspectlon shall be made 24 hrs.in advance•phone 259•8810. 11T1-S f98.� � <br /> ' 2.All work shell be pedormed in accortlunce with�his nermil end cmrent City ol Everett Oe.sip��lruction <br /> Stendards and S��ecilicetions. <br /> 3.Call Location Underground Service 48 hrs.bebre you dig.TOLL FREE NUMBER 1-800��555 � � <br /> I __ , f736.88 <br /> � � /', CU�n dr.��e.���.[/ Zi���anGG' Z�u 20�L'er Ci�j/ O <br /> � �' no�ar�o� �3oB. / <br /> I �1� CUJ7'lB�'f¢O� ZO Q IYletdrCt� � <br /> 5. ,�'.tio Nouse r�vs f .�ic <br /> '�' UJ,L.fy/ /.�illin�, //\ <br /> �un.t�e r Servic¢ — r�af. �/ V♦ <br /> l�I�� � <br /> � <br /> a <br /> - <br /> . ACKNOKLEDGEMENT OF CONDITIONS <br /> The undersigned ownedapplicanl hereby agrees to hold and save harm- <br /> less the Ciry ol Everetl irom any and all claims lor tlamages, costs. <br /> ����////// / � ezpenses, or causes ol action Ihal may arise hecause o� inslallation <br /> //J ���)and maintenance of ihe improvement or other righ4ol-way use hereto <br /> � -�-%T apolied 1or and lurther agrees to remove same upon notice irom Ihe <br /> Appro�etl�on5��u�f�p � ,� .�b�� Ciry and lo replace public property damaged Ihereby. / � <br /> � � <br /> _,�--_�-���;,//'�c, .z y_ y, ��)� y///;;;'/�y� /�'�D <br /> . FINAL INSPECTION Date — �J.Sd[_._� � �, <br /> Approved as Constructed Signaturc ol �>ppli nt Da;e <br /> �WORK AUTHORIZED 8V THIS P[RMIT MUST BE STARTED WI�HIN <br /> everett PUBLICWORKSDEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER f5 TG <br /> � 3200 Cedar Street BE DILIGENTLV PURSUED TO COMPLETION.1HIS PERMIT MHY B[ <br /> Evere�L WA 98201 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON iHIS <br /> Phone:259�88t0 PROJECT OVER 90 DAYS DURATION. <br />