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�r� <br />Q�`�xi <br />9Hcn <br />y �� <br />�C c) <br />H� <br />O x0 <br />" H �J <br />C/� H <br />y r <br />�o� <br />� H t7 <br />O �-+ <br />��g <br />G� � c❑: <br />9 H L�7 <br />r z <br />HH <br />g`� <br />H <br />C] C7 v1 <br />��� <br />H O tNi� <br />8/5/92 <br />Date <br />�/ � " <br />� .piiwlion For <br />4 3l� <br />� PummlvmwaPrue'n+ _ - .. - <br />oie9 oen� . 37G1S <br />PUBLIC WORKS PERMIT <br />TO POSTING_ �-�3 <br />Print or Type Only <br />Rose Brunson 216 W <br />Glacier Const <br />Applicant <br />Describe Proposed Work <br />335-7709 (William Short <br />6liiiin9 Address <br />New SFR w/mother-in-law apt <br />Ci�y <br />Ci�y <br />206 W Dfarilyr. \ve S.P. lt <br />Project Atldress lii known) _ <br />f�ubl¢ Wo�ke Pce g <br />Talel Fee - - <br />Lc9s A001. fec PeN S �= _.. <br />❑.�Ilrc.nflnr �V' .'1�%� <br />Attach lour (4) copies 01 vlan5 lor proposed work � Draw lo scale antl note � Ceoterline of sneeir.�c I'. <br />• property Lines • Indicate North <br />• Outline and dimensions ot all ex�stmg and � Show any proposed pradm9 ch�nqes <br />pmposetl siructures on thc lot � Show n��easuremenis <br />• ExiSting anA ProposeA uuhtics <br />�,00e <br />� � PERMIT CON�IiIONS <br />� ' 1. All calls for inspection shall be made 24 hrs. in .�9vance � phone 259•881 O <br />�� 2. All work shall be pedormed m aceordance with thls permit and cunent Cny o� [�e�ett Desi9n and Construction <br />Standards nnd Speciliwtions. <br />3. Call Localion Underground Service 46 hrs. before you di9. TOLL FREE NUMBER 1•800•424•5555. <br />'« y <br />.... ` <br />1o��ic-� � ��/�� <br />qpprov Q lor Cons cllon / Dale <br />� �`/'� !" ' /'� /(,///i.`- <br />IN L INSPEC I� y� Datc <br />Fpproved a5 Consirut�ed <br />�PUBLIC WORKS OEPARTMENT <br />,v�3200 Codar Street <br />Everett, WA 98201 <br />Phonc�259�8810 <br />ne <br />ACKN0IVLEDGE6IENT OP CONDITIONS <br />W <br />� <br />�� <br />Y / <br />� <br />� <br />�p <br />Y / <br />� <br />a <br />Thr undersi9��ed owner,�npPlicant herebY n9rees �o hold ond save h.�rm- <br />less the Gry o� Everelt Irom �ny and dl claims for damages, cusu: <br />expense=, or tauses ol aclion Ihat may arise Uec�use nf installatioi� <br />and maiMenence ot the improvement ar other ri9ht�ol�w:ry �se hcrelo <br />applietl br �.id Wrthcr agrees to remove same upon noUce Irom the <br />pi�y and b replaca public property dama9ed Ihoreby. <br />r � <br />L�.l3� G.(/�c��{_� C����, -_ <br />i <br />L�� ;�yn 7�- 'G'�-1= <br />,� � . , i .yl • - Datr__ <br />Si9naWrc oi APplicant <br />WORK AUTHOFIZEO BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF L�ATE PERMIT IS ISSUED AN� THEREAFTER IS TO <br />BE DILIGENTLY PURSUE� TO COh1PLET10N. THIS PERMIT b1AY BE <br />CANCELLED BV i HE CI1Y UPON ANY STOPPAGE OF WORK ON 1HIS <br />PROJECT OVER 90 DA15 DUR4TION. <br />� <br />