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",` ��� u <br /> Date �� �� � � _ �'u�llc Wadn Peimlt• � U 7�� <br /> Applicetlon Por D � �f [� I� U � �ae.oep1.`—�-� � <br /> PUBLIC WORKS PER M, ., �, J�°;o,aFmFae s <br /> �,,, �. 4 15:; � <br /> �� ����I�� Lefsl.pPLFeaPPirl S <br /> � '1 �z.s'�—i7 <br /> Print or Type Only ��"I � �ry ( � r - - .�.�. . ,�$ ^_°o�o s <br /> IiIC,�f'�II,IC�i� � N � � <br /> Snohomish County Public � � � .Pv`�1°�M �'pntact: Jim Simpson, P.E. <br /> Utility District No. 1 P.O. Box 1107 Gvere 98206 �Z 206 347-4317 <br /> Owner Mailing Address �it� � � � � yi� � Phone <br /> 7� <br /> (Same as above) � � � � � �` � � <br /> Applicant Mailing Address Ci�y Zip Phone <br /> Desc�i6e Proposed Work Construction of an electrical switchine station, also known_as "Delta�� <br /> Switchin�Station <br /> � W <br /> ProjectAdAress(ifknoH•n) 201 F.ac_t Marine View Drive� RvP�rPtTTWA_ � <br /> Attach four(4) copies of plans for proposed work• Draw to scale and note the tollowing as applicable: � <br /> • Property Lines • Centerline ot street � <br /> • Outline and dimensions of ell existing and • Indicate North <br /> proposed structures onthelot • Show any proposetl grading changes <br /> • Existing and proposed utilities � Show measurements � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS O <br /> 1,All cnlls for fnspeclion shall be medE 24 i�rs.in advance-phone 259�8810. � <br /> 2.All work shall be pertormed in accordance with ihis permit and curcent City of Everett Design and Construction <br /> Standerds end Specificationa <br /> 3.Call Location Underground Service 48 hrs.belore you dig.TOLL FREE NUMBER 1•800�424•5555. � <br /> `� �tir G���-.� .to lr..� d� ��2„�v- a��a,t o,.<.� � <br /> o� � .��/qf� �1y �cw2tGZf- ���iLcd <br /> f/ �CU�d c%OCr�Z�',.,a+,.7� . <br /> S. .�'.�c Pt!D� o%sz`� h�2 cUm�,,ti-fz��� � ���.� � <br /> ,z�, .c�c/ �'.� -c�` .�/ ���1'� s�z� �� O <br /> Lf�'Q�jati,Vn'^��' �"'�'�`✓" �/'"`'i �Q�L°��. �n�r�rfn Jt�li� � <br /> � ✓ <br /> bv-� y,�-� � _��c��G �/�,90���'- <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicanl hereby agrees to hold and save harm• <br /> less the Ciry ol Everett irom any and all claims for damages, costs. <br /> expenses, or causes ol action that may arise because of installation <br /> 6 � z y� and maintenance of the impwvement or other right-obway use hereto <br /> applied for and Further agrees lo remove same upon notice Irom the <br /> Ap rove,. or Co9�t �' c Dat Ciry and to replace public property damaged thereby. � / <br /> G/ a;� J�� <br /> .�%G`,! ,,.--�- ic-i Y•sj- � <br /> FINAL INSPECTION � Date <br /> Approved as Constructed S' nature o pplicant Date <br /> � PUBLICWORKSDEPARTMENT WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br /> 3200CedarStraet 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> Everett.WA 98201 BE DILIGENT�Y PURSUED TO COMPLETION.THIS PERMIT MAY BE <br /> Phone:259�8810 CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> PROJECT OVER 90 DF.YS DURATION. <br />