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� � b <br />��� <br />o�o <br />�e�ro <br />�I! M <br />� N � <br />M EO �p(�p(�p(yyy��� <br />M , � <br />R N <br />C ~ <br />M <br />Vl <br />WN � <br />O � <br />�_�-� <br />Date�l�t_!CJ <br />ApPlica�ion Foi <br />PUBL!C WORKS PE�RMIT <br />Print or Type Only <br />Mailin9 <br />Applicant <br />Describe Proposed Work <br />v <br />Clry <br />Gp <br />q,necwnnsrnini � /C� �� <br />o�n� o«n� � <br />��„�,�,�,�a�.,..� 5 -- <br />,a,.,�.�� <br />Less AY01 rev va�n 5 �/�• <br />Paiancu Dun S. W <br />P�olect Adtlress lil known) �Z O Ei1�AhJ'� /�c L <br />Altach lour 14� copies ol plans lor proposed work - Draw to scale and note Ihe lollowing as apphc�bw:� <br />• Property Lines • CeNedine ol sireet <br />• Out6ne and dimensions ol all existing antl • Indiwte North <br />proposed Structures on ihe lol - • Show any pioposetl 9'admp changes <br />• EMiSting antl proposed utilM1ieS • Show measu�ements <br />��� <br />PERMITCONDITIONS � <br />1. All calls for inspection shall 6e made 24 hrs. m advance- phone 259•8810. <br />2. All �v:,rk shall be penormed in accortlance with Ihis Germit and current Cily ol Evere�t Design and Cons�ructior <br />Standards and Specifiwtions. + <br />3. Call Lxalion Underground Service 48 hrs. belore you dig. TOLL FREE NUMBER 1•800•424•555$. <br />..T. i00F PR-AIN`� �+41lLLL �C �l'iNNFZ.TCi�� VI�CGTU� Ta 61L� 5�-W1�2,. <br />M � <br />�IO (i1Z.A��lA4,C �NAt_l. eC LJ�kt--L-lZ-I'> OVL.�L i��C �N�� . <br />/� <br />i I <br />���� <br />�� ApPmved lor <br />n <br />C <br />FINAL INSPECTION <br />Approved as Consimcted <br />evemtt PUBLIC WORKS DEPART1dENT <br />� 3200 Cetlar SIreM <br />Everctt. WA 98201 <br />Phone�.259�8810 <br />i'_ . ....,.. <br />�� �-�o <br />Date <br />W <br />� <br />� <br />N <br />� <br />O <br />� <br />N <br />O <br />a <br />ACKNONlLEDGEMENT OF COND�TtONS <br />The undersigned owner/applicant hereby agrces �o hold anA save harm� <br />loss thc Cny o� Everetl Irom any antl ;dl claims lor dama9es, costs. <br />eapenses, or causes ol aclion that may arise tecause ol insWlla6on <br />and maintenance of ihc improvement or olhr.r n9hl�obway use herelo <br />applied lor and �urther agrees lo iemove same upon nollce hom the <br />Ci�y and to replaCe publiC proper�y tlamagetl Iheteby <br />.��J �,�' <br />�nalure ol ApPli[ant Date <br />ORk AUTHORIZED BY THIS PERMIT MU:iT BE STARTED W�THIN <br />iB0 DAVS OE DATE PERMIT IS 1SSUED AND THEREAFTER IS TO <br />BE DILIGENTLY PURSUED TO COMPLETIO�. TNIS PERMIT MAV B[ <br />CANCELLED BV THE CITY UPOPI ANY STOPPAGE OF WORK ON THIS <br />PROJLCT OVEL7 30 DAVS DURATION. <br />