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�� li . 1. � <br /> � . ..�, � ; , <br /> 1 : ,� , �� , . . <br /> � , , . ;� ' nonnr,i�o�F�,� Date _ SuLy—��} -�99 y <br /> i <br /> PUBLIC WORKS PERMIT public Works Permi k __ _�2QZ., . __ <br /> PUBLIC WORKS D[PAH�M[NT (� �� <br /> 3200 Cedar Strect �T�(,(� d�� Z,U ZZ) <br /> „Everett. WA 98201 (�25) 257�8810 Buildmg Permd a _ <br /> TYPE OR PRINT ONLY � Publ�c Works �ee S <br /> �82 �O <br /> �oaTuk�esr PbNE0. CO LLG �00Uu�vER58 B�vo 7'uuoBswcr+ 33408 (9to�- ldil -2210 . <br /> Owner �• l.taihng Atld�ess Gty Zip Phonc <br /> ,B�4clt AunVFRiGH �Beuceeau.� 1toTw,RoA�e S�e IIoO, SEatr�E IiJ,,�.9E�o�i (2oe� 2Zy- ye38 <br /> Appl�.Wnt '.'aihng Atltlress C�ty Zip ' Phone <br /> Describe Proposed Work S iTe P�E��RAT�01J Foc�__�E_Fu�uRE c.p�,l.g_L�u.Tio►.1 pF p W <br /> QoWER �IJaNT._I�1CLu0ES . FJNA4_6RADiNG OF ZALRE_S!�'E. US�NG _ � <br /> _AQ�4XIM9'TELy�,00o Cu.B�4 YA_R_DS_9_E_I�oltTED _FILL-'- - --- -- �. <br /> PROJECTADDRESS (ifknown) _ I �.{ E. MPa�►�E �IfiW �R . _______ � <br /> , • O <br /> Attach lour(a�copies.0ians lor G�oposed work � Draw to>cale and note ahe Io�iow�ng �I appl:cable. � <br /> •Pioperty Lmes •Outhne and dimensions ol ail e.isung and proposecf svuctures on the toi •E�istmg and proposcU ut,�.�nes <br /> •C�nledine ol sl�eet •In�icate North •Show dny proposed grading ch;tnges •Show mcasuremmts �J' <br /> DO NOT WRITE BELOW THIS LINE ` <br /> PERMIT CONDITIONS' '. O <br /> 1. All calls lor inspection sh�ll be made 24 hours in�advance • phone (A25) 257•8810 <br /> 2. All work shall be performed in accordance wtlh this perm�t and current City of Evere�B,e,"sig�aRdQaA�� � <br /> Construct�on Standards and SpecificaUons. � %'����� <br /> 3: Call•�ocation Underground Service a8 hrs. before you dig. TOLL FREE NUMBER 1��93424-55��:�00'BM '/� <br /> OPic� 182o70-0P VJ <br /> � ' / OTR! Z8?.70 <br /> � ��2�'� � 8G p0I7e �1/ �CF.ftd� ��e� � ��j�o �A�: - ' .'J� .0 <br /> �uer�f/' R.6l�G wor,Et o�ey7`_ O n �-a¢- �y c'�Py °��S��d��x�.� a' � <br /> !. JJi%s wor,E .f'fx C� Con�'orrn t�o fhe NPDES Pe�m%� - ` <br /> �/� T�/iS PI'OP�r�t/ , <br /> � <br /> �ji. �g¢�J C t�/ .S'�/'e¢fS C�2 4 n �1 f Q�L f'irr�S , � <br /> ` _ ` ��C��c r e C� `—�� �cr-�� c�ov� � <br /> � c�oSe� z��� -is <br /> ACKNOWLC-DGEMLNT OF CONDITIONS <br /> _ �/� A� / /� The untler,igned owner/applicant hereby agrees to hold and savc haimless <br /> ��� �� 8 �¢. Ihe Gry of EverCn Irom any antl all claims tor damages,cosu,expenses,or <br /> pprove or ons ruC ion �� causes ot acUon Ihat may ari5e 6ecause ot installallon antl maiNenance ol lhe <br /> ' , , I impmvement or other n9hi�o6way use hcreto applied for and funher agrecs Io <br /> : , . . � : , remove same upon not�.e ir �i the Cily and to replace�bl� ,p,r�pc�ty�da(n� <br /> . � . ' � a��th ,.�y . ' _� �l() P�..7I`1 �I <br /> ci�4 <br /> qppAov d asECons�trucled Date � �� " <br /> . � �gna we o pp icant � aia <br /> WORK AUi}10RIZED BY THIS PERM1IIT MUST DE STAHTED WRHCI 1E30 DAYS OF DATE P[F7h1R IS ISSUED/WD T}1ERF�FfL-R IS TO BE DILIGENTLY AURSUED TO <br /> COMPLE f10N 7HIS PERMfT�,LiY BE CANCELLEC�BV TiE CfiY UPON M1Y STOPPAG[ OF WORK ON 11115 PRQIECT OVER 90 DAYS WHlRQ10N. <br /> i <br /> � <br />