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Date 4/18/95 R <br />Applfcatlon For <br />PUBLIC WORKS <br />Print or Type Only <br />Lqle Blenk PO Box 2266 <br />MaiBng <br />DescriCe Proposed Wcrk NeW <br />P�oject Addreas (if known) �2� — <br />7 —Zt�- � <br />s�r3 POSTING <br />PE�MIT <br />Or� <br />tl <br />��+o�oo 0 0 0 <br />Q oonr_�u�a �ou� <br />j� �Q r�oci�:o o�oo: <br />" �O `A .r an N h Q� � <br />'p' M M N M ,�l M CJ U <br />v�re�t 96203 �5-q�� <br />�_ �. <br />City c�� � c5 — <br />O L U �((�j� �p0{3�� <br />r'�U 2]_ �u Vl p� iE fn <br />sgeto 154 <br />n� <br />n � <br />PuCiit WOA� Pumit • .s �pe � <br />eiao o.ai.. 98092 <br />nic Work� Fas <br />To1sl Fae i <br />Ln� �pp� Fee Pa�U i <br />B�iance Due j Z�! 00 <br />Phone <br />��P Phone <br />Attach fou� (4) copies of plans lor proposed work - D:aw to scale and note the following as applicable: <br />• Proparty Lines <br />� Outline and d?mensions of all exiating and <br />proposed structures on the lol <br />� Existing end proposed vtllities <br />� Centerline of street <br />� Indicate North <br />• Show any proposed gradinp changea <br />• Show measurements <br />PEAMIT CONOITIONS <br />1. All calls for inspectbn ehall be made 24 hra In advance • phone 259$810. <br />2. All wprk sh�ll be peAprmed �� a�pbe�ce with thie permit and current City ot Everett Deeipn end Conatrucllon <br />Stendarde end Speclfk,atlona <br />3. Call Loc�tion Underpround Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800-4Q45555. <br />y9rs� <br />Approved as Consiructed <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 <br />Phone: 259-8810 <br />W <br />� <br />� <br />� <br />� <br />O <br />� <br />� <br />O <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undersigned owner/a�plicant hereby agrees to hold and save horm- <br />less the Cily of Everett from any antl all claims for demages, costs, <br />eKpenses, or causes of action that may arise beceuae of installation <br />and maintenance of the improvement or other righhof•wey use hereto <br />applied for an rt rees to remove same upon notice from the <br />Ciry and to plac u c property damaged thereby. <br />�/� �30�.� s//�� <br />w�NK HORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />780 D S OF DATE PERMIT IS ISSUED AND THEAEAFTER IS TO <br />BE DILIGENTLY PURSUED'.O COMPIEiION. THIS PcRMIT MAY BE <br />CANCELLED BY THE CITY ��F:: N ANY STOPPAGE OF WORK ON THIS <br />PqOJECT OVER 90 DAYS OURl�TION. <br />