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�n_ta,"S$ <br /> D2fB n�ma wo�u� <br /> AypliWtior For P�ao oeot• <br /> PUBLIC WORKS PERMIT °°°,o;:�.;�•. : <br /> �..,.00<<..P.,�s <br /> e+�,.<,o.� f <br /> Pri�l or Type Only — <br /> �nnhrmi�ln C'n � t�rl�f'P�k� ���- ��a�c�l <br /> Owne. Mniling Adtlress Gry 2ip Phone <br /> « '� i �n� � 5� a31 a Cr�,l�,_�_.i=Y_�'�l �a�� <br /> ApPhca MaJmgAtltlress Cit Zip Pnone <br /> DescnbePmposedWork �,yi �� � L11�--���--T- 1��, <br /> P�o�ecl Adtlre551��knOwnl E -` ' '1 ` — �� -- � <br /> Altac��ow�4�ropies ol plans lor O�apnsetl wo�M-Draw to scale nnd note Ihe lollnwing as npplicabie�. � <br /> • Roperty Lmes •CeNedine ol slreel /A <br /> •Outlme an�Cimensions oi all c.isling and • Inrhwle North y) <br /> pmpose0 slmclures on Me lol •S�ow nny pmposed giadrng c0ange5 <br /> •E�istmg anC pmpoSeA uhhhes •S�ow measurements � <br /> DO NOT WRITE BELOW TNIS LINE O <br /> PERMIT CONDITIONS <br /> 1.All Calls tor inspeclion S�ell be made 24 hr5.in ativante�phone 2$8•8810. �' <br /> 2.All work s�all Oe pertormetl in acmrdance wiih 1�is permil antl cwren�City ol Everetl Dosipn antl Consimction <br /> SlenCar05 and Specilicnlions. <br /> 3.CaIILocationllndergwuntlSe�te48hrs.belcreyoudig.TOLLFREENUMBER7•600324•5555. M <br /> \ � <br /> O <br /> /1/� �• { N <br /> �� 8/�� o <br /> � <br /> a <br /> ALKNOWLEDG[h1[NT OF CON�ITIONS <br /> T�e untlersigneC owneUapPl¢ant�e�eby aq�ees lo I�oitl antl save�mm� <br /> less t�e City ot Everelt Imm any and all claims lor tlamapes. cosls. <br /> e�penses. or causes ol nchon Inat may anpe bewuse ol Installalion <br /> 3nd mamlenanLC ol��e impmvemenl or olher u0��'o4wBy use berelD <br /> aon��ea m�nntl�urher a�rees to remove same uoon nobce Irom the <br /> APP�oved lor ConsiruClion Uate City and to replace public�roPerry tlamagetl I�e�eby <br /> FINPL INSPECTION Dale <br /> ApproveG as Constmcletl SignaNre ol ApP��<ant Dale <br /> rc�vrll PUBLIC WORKSDEPARTMENT WORK AUTHORIZEO BY iM15 PERMIT MU51 BE STARTEO WITMIN <br /> � 3YOOCedarSireel 180 DAVS OF DATE PEiiMIT IS ISSUED AND TMEREAFTER IS TO <br /> Eve�el4 WA3820t BE DILIGENTLV PURSUED TO COMPLETION.TNIS PERMIT MAV BE <br /> P�one.459-8810 CNNCELLED BV TIIE CITV UPON ANV STOPPAGE OF WORN ON THIS <br /> PROJECT OVER 90 DAVS DURATION. <br />