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�� <br />� <br />TYPE OR PRINT ONLY <br />Describe Proposed War{t <br />PUBLIC WORKS PERMIT <br />PueuC woRKs DEPMTMENi <br />3200 Csder Strsst <br />Everstt, WA 98201 259-8810 <br />TO POSTING DE_ <br />' �:W 51 <br />PRWECT ADDRESS Qf known) <br />p� 5/19/97 � <br />RibNc YVala Pamdf N Z <br />BuHdlnpPermR1 SSli9 <br />���,�: �»�m� <br />Zip <br />Attech tour (4) copies of plana for propoaed work - praw to acale and rqte Hy fdbwiny ry applirayb; <br />'Property Unes �OWllne end dhnenabns ot ell ezlating and propoaed atructures on tM bt 'Exiati� and proposed ulNlllae <br />`Centerline ot street �Indkate NoRh 'Show anY proppyed predinp ohenfpy •grypw me�yuro�n�e <br />PERMIT CONDITIONS: M � �.9501 <br />1. All calls for inspection shall be made 24 hours in advance - phone 259-BQi�pER 13p,pp <br />2. All work shall be pertormed in accordance wfth this pennR and current Cirj ot Everett D� and <br />Constructton Standards and Specificetions. yp� ��� <br />3. Call Locadon Underground Service 48 hrs. before you dig. TOLL FREE I�NJMBER 1-8p�1-QQa6. <br />� �.�,r �� �r�� � � 8 -z�"��:n <br />�,�, �. <br />�,�.� <br />M 9504 <br />IM11FR 530.00 <br />T07AL 2967.87 <br />,. ,.T'7I-i:7 <br />� <br />� <br />0 <br />a <br />CHEK 2967.87 <br />ACKNOWLED(iEMENT OF CONDIi10NS <br />The undersigned ownx/ePWM.ant hereby pren to hdd and aave harmbss <br />the Ciy ot Everatt from eny ary all cldma for demepea, cwp, e�cpennaes, or <br />causes of actlon that may arbe becauas o} ImfeNptbn end malntenence of <br />tlx Improvement a other rlpht-o}•way we hsete �pp�yd }p yb ry� p�y <br />to �„o�e seme upon nonoe rrom me cny arw ro repls¢e q,blb p,openy <br />demeged tlbreby. <br />� <br />u f Applkant �`_ � <br />Dete <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAVS OF pATE pEqM IS ISSUED AND THERFAFIER �S Tp gE qLN;ENi�y p�qgUEp Tp <br />C�OMPLEf10N. THIS PERMR MAY BE CANCELLED BY THE CfTY UPON ANV STOPPM(aE OF WppK pp� 7ry1$ pqpJECT QyEq g0 p�yS WM710N. <br />I <br />