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f <br /> x � 'il <br /> C+1 <br /> O x <br /> C", H <br /> 9HCn <br /> M <br /> H ._ H <br /> FC C] <br /> H �1 <br /> � xo� <br /> y ; <br /> � 7.�� Date 9 3 91 v��oi���vo�Fsr„�m�i, _ . <br /> �.� o �iCq Dcol .�1.�26�25--- <br /> y rJ 4pPlicalinr, For <br /> ��g PUBUC VVOR!(S PERMIT P���'<Wo�MSFce <br /> iotal Fcc 5 <br /> N LessAppl FeePnN S <br /> xy N �:��,��..�„� s <br /> I� H y Print or Type Only <br /> O � <br /> H <br /> e1 C7 v� <br /> C�C r Dlelvin flridgham 14905 xWX West T.,1: Goodwin Rd Stanwood 9�291 652-7943 <br /> i Phone <br /> ����li7 Owner �lailing Atldrets Ci�Y Zip <br /> HOfyi� <br /> Goo�Ss�n�•r dba Nt9 Gar�9��_1121.7-6Qth Gr nF rk sr�ens ��4–Q2G2— <br /> Appli<ant Mailin�AAdress Ci�y Zip Phoiie <br /> Descrihe Proposed Work ConStLUCt new qaYaqe — — <br /> W <br /> Pro7ect Address 1�� known) _ �4�1-.I�llnl�r nr — � <br /> � <br /> Attach wur IM1) copies of plans for proposed work� Draw to scale anA note the following as appl cable. � <br /> • Properry Lines • Cen�erline of streel <br /> • Outline and dimensions of ail ezisting antl • Indicale North <br /> f�' proposed struc�ures on the lo� • Show any proposeA 7radiny ch,m9es <br /> • Lzisting and proposeA utilities • Show measuremenis � <br /> 1�' DO NOT WRITL 6ELOW l 115 LWE O <br /> ��� PERMIT CONDITIGNS � <br /> 1.All calls lor inspeclion shall 6e made 24 hrs.in advance•phone 259•8810. <br /> 2.All work shall be pedormed in accordance with this peimit and wrrent Ciry of Evereu Des gn and Construction <br /> '�' Standards and Specilications. <br /> 1 3.Call Location Underground Service 4d hrs.before you dig.TOLL FREE NUMBER 1•800•424-5555. � <br /> ' �UL��GG CCJO_'G�J'/�c'�:'�1.Gf/(/c➢7 /�('ty'�GUL:�4', � <br /> �� b � <br /> �' �' L) <br /> t] I— <br /> � �,:S-1y �n <br /> 1"f � <br /> �_i a, <br /> �1 <br /> �1CY.NOWLE�G[\i[NT OF CONDITIONS <br /> The under.,9ned owner/apPlic2nl heiebY agrees to hoid and savc hann� <br /> — — --- � Iess Ihe Gdy ol Everett from any nnd all ela6ns for duma9es r.usls. <br /> expenses. or causes ol actlon ihal may arise because ol instail.��ion <br /> .nd mamtenance of �he improvement or olher riph4o���vaY i�so heretn <br /> applied for and luriher agrees to remove same uPon nohcc Irom Ihc <br /> A�,provr.d toi ConsVuct�on Date City anA to replace puhGc proPerry damaqed therebY. <br /> FINAL WSPECTION ���� ����Q <br /> qppwved as ConsLu.Ied Sinnatu:e o�Applicant <br /> WORK NUTHORIZED BY TNIS PERMIT AtUST BE STARTED Wlll!IN <br /> Oevrrclt PU6LICWORKSDEPARTMENT 180 DA1'S OF DA7E PERMIT IS ISSUED AND THEREAFTER IS TO <br /> 3200 Cedar Street BE DILIGEN1l V ?URSU6D TO COMPLETION. THIS PLRAtIT MA1' 6c <br /> Everetl.WA9R201 CANCELI.EL 3Y THE CITY UPON HNY STOPPAGE OF IVORK ON THIS <br /> Pl�one�.2ti9-B810 PROJECI"OVER 30 DP.YS DURATION <br />