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��� <br />��x <br />C H <br />9H� <br />r <br />H�� <br />�H� <br />'�qH�U <br />!/� H <br />�O� <br />OH� <br />H�8 <br />•y� Y n <br />xy+ H � <br />ryz <br />HH <br />N <br />H <br />e�C7� <br />� � [=1 <br />Z H !n <br />F30a, <br />I �� <br />,-- <br />��-,, <br />� �� <br />�a:E:l,�..--., � i—`r `' <br />A;;Phcntirn Poi <br />PUBLlC W'�)�a�� pERNIIT <br />Print or Type Onry <br />�—. I,� (1� �/'� ���1 � � ��1� <br />� � i <br />Ownei <br />��nflir,an� <br />pescn7c Proposed Work <br />A']d�ny rldflrCSs --�_�.'I�i <br />P�olect Address I�� known) ' 't�-�'— <br />f.l;ach fow 1�1) cop�es of Plans for Proposed wo�k <br />r�v <br />�..,,: r.�,.. :::;,—�-� �G� ;' <br />U,f9 Dn�i . �L� � �..- .�:1 J <br />I'uL��rWm�sF� 5- —_—... _ . <br />in�.��fur _�-- — <br />� �__'�:�;�.. .,,. 5�-- -- _--.-- <br />!ip <br />Zip <br />Orar: to scale and ��ote Ihc tollowmg as apphcaUic. <br />• Property Lmes <br />• OWl�ne und d:menslo�s o� all e��sling ;o�d <br />proposetl slruC W res on U�e Ict <br />• Exis�� �y entl proposed iddi���s <br />• Centerline ol sireet <br />• Indicate North <br />• ShoW a:�y Pr,�nosi�d 9ruAinq Ch2m9es <br />• S��o�v mea5uieinenis <br />Phonc <br />PERMiT CONDITIONS <br />1, All calls for inspection shall he made 24 his. in advance - phone 259•8810. <br />2, All work shall be pedormed in accordance wilh this permil and current City of Eve�elt Design and Consiruction <br />Standards and Specihcalions. <br />3. Call Localion Underc�wund Service 48 hrs. befoie yeu di9. TOLI FREE NUMBER 1-800•424'S55 . <br />�. - �� <br />� ��� �:Y,L`_ �rc'I <br />� r, . <br />ApnroveA for Construction <br />Dalc <br />Date <br />FIN�L INSPECTION <br />,lpproved as ConsltucleA <br />�,�i,��q� PUBLICWORKSDEPARTMENT <br />� 3200 Ced�r Stree� <br />EvcrelL �M1'A 99201 <br />Phone.':59�8ft10 <br />Z <br />n <br />AG��NOAVLEU�,�t�1EM OF CONDItIONS <br />Th+� undersigneA o�vne�; apGhcanl he�eUY agrees Io hotd and stave ha�nr <br />Iess the Cily of Everetl Irom any and all claiins lor dama9ea co��s. <br />exP���ses. o� causes o� ac�ion that may anse becaus�* o� installation <br />and mauilanance ot the imProvemenl or oVtet r�ght�obw;�v u>,� ���'��'�� <br />aPPlied �or and iwthor a�rees to �emovc same up��� ���>��.-�> f1O^' tl�c <br />GdY ����f to �ePlace p�iUhc ProperlY dainaqed IhemUy. <br />--._ D,�to __ <br />SiUnatwe o� Applir,anl <br />WORK AUTHORIZED EY TNIS PER�tIT MUST BE STARTED �VItHi�J <br />180 D�YS OF DATE PERMIT IS ISSUED AND THEREAFTEF i5 i0 <br />BE DIUGENTLY PURSUED TO COMP���O�N����� PFR�� � iN i1,�5 <br />CANC[LL�-D 8Y TFIE CITY UPOf I AN <br />PHCJf.C1 OVfJ770 D/1YS DURATIO� <br />