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pumiC RICg PERMIT <br />miewwommov iiirmwir <br />aw caer "" <br />emw%WAN2st 2164" <br />TYPE OR PRINT ONLY <br />1dt 01 PIAC*Qt <br />Wew G rAea <br />PROJECT ADDRESS (if known) <br />�. <br />Pak Yefrlta Perwa 0 <br />sttl to pw" # A.53134 <br />Prblc wbb Fee l{ <br />L": <br />Attach four cq copies Of p1611e for proposed work - Draw to seals NW na.1M faeewkq a apploabb. <br />epropeny Lerss s0u"ne and derweii m of al exW" and pAP,d ctructirse on the lot 4.x"V and ropoodutMaa <br />'Contrtine of sheet slrl td* North %huw ally proposed gru" citenWM % ow ffwmulamrda <br />PERMIT CONDITIONS: <br />1. All work <br />for inspection shad be thours advance this �* phone � Current City, 0. <br />of EwtNt Design end <br />2. All work shed be psrfomted In acc=Wm <br />Construction Stcndards end Specifications. <br />3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NIJMlER 14/00-4244OBS. <br />Nps rn;�- <br />Approved for Construction De1B <br />FINAL INSPECTION D81e <br />Approved as Constructed <br />W <br />CO) <br />90 <br />10) <br />Z <br />0 <br />0 <br />0 <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />The undwsVad ownx/W(>IkaM hereby apses so hold and saw MMOM <br />the Clry of Everett from any and ON alaerN for denr0ee, ooab, spate", or <br />causes of action that may rim beeauu of Ntstalal', mrld ansintrtrtaa of <br />the Ynpmwnwlt oroitterdgM-d-wy use Ml lo, oppledfrrtd halo apes <br />tto__.m, r__em,.ove,� aanl* upon nodoe front the City rid to mphm publc roa«ty <br />Jw"� thereby' <br />Sgrtature of Applicant Do" <br />WORK COMPLETION. THIS PERMIT MAY BE CANCELLED 13� E CITYIUPON ANY ST�OPPAGE�wORK ON iF� PROJECT O O YO DAYS DU'"ATK*' n�M� <br />