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� :, <br />� � 'L <br />q�� <br />~p�y�p <br />71��0 <br />� <br />Zo <br />�NC <br />H Iltl <br />�>y <br />C" y <br />M <br />W <br />nM <br />W � <br />�� <br />� <br />ll �� <br />Date 2'4-93 <br />qpplication For <br />PUBLIC WORKS <br />Print or Typa Only <br />8800 Hwy 99 <br />Owner <br />Describe Proposed Work <br />�3_ 3►-Zq -5 <br />� .� <br />G � <br />P�E�F�'►� <br />H Lynnwood WA <br />cnv <br />/ <br />P�ol¢ wo��e Pa�m�� • � 3 5� <br />zoi�n <br />ai0p �eol • <br />Puohcwo�ksFee s <br />ta,r, Fea <br />le»�OC�FeaPe�� s �m�—_ <br />BalOnce Due ..V <br />78-75 <br />- �...— — .__.. . -- <br />Prolect Address lii knownl <br />Attach four (4) �oV�es o� Plans lor proposed work � Draw to scale anA note ine tollowing as apulicable: <br />• ProPe�ty Lines <br />• Oulline and dimensions of all ex�sting anA <br />pmpased slruCtures on Ihe Ioi <br />• Eaisting and proposed utilities <br />• Cenlerline of s�reet <br />• Indicate North <br />• Show any propoSeC grading changes <br />• ShOw mea5ur@m0�I5 <br />PERMIT CONDITIONS <br />1. AI� calls for inspection shall be made 24 hr-, in advence - phone 259�8810. <br />2. All work shell be performed I� accordence with ihis permil and current City ot Everett Design end Construction <br />Stantlards and Specificetions. <br />3. Call Locatlon Underground Service 48 hrs. belore you dig. TOLL FREE NUMBER 1•BOO�:Z4•555 . <br />a 118I � •�m �X J � iV1G � �„/- <br />�, Pa� �r� �Gway :u�}� � <br />� � �n ��9h�t,-o�-�� Cm;�irN�A+�) <br />FINAL INSPECTION <br />qpproved es Constructed <br />S�PUBLIC WORNS �EPARTMENT <br />92p0 Ceder Slreet <br />Everett. WA 98201 <br />Phone: 259-8810 <br />L <br />� �� <br />W <br />� <br />� <br />� <br />� <br />O <br />� <br />� <br />� <br />a <br />AGKNOWLEDGEMENT OF CONDII"IONS <br />The undersigned owneqappliwM hereby agrees to hold and save harm� <br />less Ihe Giry ol Everelt Iwm any and a�l claims for damages, costs, <br />expenses, or causes of action that may arise because of installation <br />an maintena�ce ol ihe imp�ovement or othe� righPof�way use hereto <br />apP <br />I d lor and �urlh g«es to remove same upon notice Irom the <br />Ciry ❑u lo replace� bli properN damaged lhereby. <br />If <br />Date ' ..���. - � ' Dale <br />Siqnalure ol Apphtan� <br />80RDAYSTOFRDAT�E PERM TS SE SSUED AND THEREAFTER ISHTO <br />BE DILIGENTIY FURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON Tt11S <br />PROJECT OVER 90 DAYS DURATION. <br />�U <br />� <br />