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O �� �� ikaiion For DatB �— /� _9� <br /> � RKS PERMIT <br /> � C RKS DEPARTMENT P s Pertnit e <br /> M AY 13 qg9g 320o Cedar Street <br /> Everett,WA.98201 (425)257-8810 '6v Jauilding Pertnit N <br /> ......._ f �•i <br /> �ITY OF EVERETT <br /> e�rinplPuoi�,c Servicus <br /> TYPE OR PRINT Cftl1�' n'J Pubiic Works Fee$ _ <br /> ..,� � ���I <br /> I ha�,as � N�u���cc� Q�e�� o��� � Ev��H 9�rzv � Cv2s� zsz -�soY <br /> Owner Mailing Address City Zip Phone <br /> ,Savhe a s a�ov� <br /> Applicant Mailing Address City Zip Phone <br /> Describe Proposed Work vV Jv� �i KC, v v � N w W <br /> c� Y rl✓ w w � I( w c. c/ b� � <br /> r ' �- - d f o , � <br /> PROJECT ADDR�SS !if�cnown) lid <br /> Attach lour(4)copies plans lor proposed work-Oraw to scale and note the following it npplicablo: O <br /> •Proporty Lines •Outline and dimensions of all oxisting and proposed structures on tho lot •Ezisting and proposed utiliNes ' <br /> •Centerline ol street •Indicate North •Show any proposed grading changes •Show measurements <br /> DO NOT WRITE BELO THIS LINE Z <br /> PERMIT CONDITIONS: p O <br /> 1. All calls toi inspection shall be made 24 o in adrance - phone (42 257-8810 <br /> 2. All work shall be pertormed in acc ce ith this permit and curren 'ty of Everett Design and � <br /> Construction Standards and Specifi tions. , <br /> 3. Call Location Underground e 'ce 4 h s. betore you dig. O FREE BER 1-800-424-5555. ♦/� <br /> ♦// <br /> � <br /> , --� <br /> .- _ �----� �� a <br /> � � qJ� <br /> ��,��y �� <br /> . �, <br /> � ����N I <br /> - -- _- � Q� �C°` \ ' <br /> � - �--- , � <br /> �� -- � <br /> �._— __ — � <br /> .,; _ _ _ _-- � <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/appiicant hereby agrees to ho10 end save�armless <br /> the Ciry of Everetl irom eny and ell claims for damages,costs,ezpenses,or <br /> pprove or ons ruc ion a e �auses of action that may arise because ol insta�ladon antl maintenance of the <br /> improvement or other righbof•way use hereto eppliad fa and furtBer grees ro <br /> remove same upon rrotice irom Me City and to replace puDlic p da - <br /> aged th y. <br /> FINAL INSPECTION Date � /,/, <br /> /lpproved as Constructed y��/ <br /> igna ure o p ican a <br /> VJORK AUTFIOfi�D BY THIS PERMR MUST BE STAflTED WIiHIN 1B0 DAYS OF DATE PERMR IS ISSUED AND T}iEREAFIER IS TO BE DIJGENTLY PURSUEp Tp <br /> COAAPLEf10N.THIS PERMIT M4Y BE CANCELLED BY THE GTY UPON ANY STOPPAGE OF NUFiC ON TFNS pRQECT OVER 90 DAYS DURATpN. <br />