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��� <br />A�x <br />9Hy <br />Y 5b <br />yYi-�i <br />�C O <br />H� <br />'� H 'il <br />VJ N <br />x <br />��e <br />�/��g <br />y�V (i <br />9H� <br />ty n <br />F-i H <br />gy <br />c� C7 V� <br />��� <br />xyv� <br />HOp� <br />Date '� `� <br />� � S•�'I ti4 <br />Applicabnn Fo� <br />PUBLIC WORKS PERMIT <br />Print ar Type Only <br />iling <br />M.uhny AAdress City <br />� <br />�����,���,•�o,..��,,�,� � '`? <br />a,� --�/-�-( <br />nina o��oi . � . �z �_%_t(11 - <br />�,.,�,�,�,vo,�=<<.e <br />ro�.,� «P 5 -- <br />Lessanu� ����'a�u 5 <br />3�- <br />Baianr�•Dur• S __ <br />noz - 3zz -5�0 -aao -�i- �g,3/ <br />F <br />DescnbeProposedWork �c-!Mw�T 1'P1id/A.j�p. Rl o��e_�_�P���[�, <br />Proiect Address (�1 knownl �� �i �� ��LT._Ij�_�Q_! / F/" <br />Attach lour 141 ropies of plans lor proposed wo�k � Drav: to sr�ie antl note Ihe toitowm9 as apUlicable�. <br />• Property Line> • Cenledine ol sVeei <br />• Outline and dimensions ol all exishn9 antl • Indiwle North <br />proposetl struclwes on ihe lot • Show any pruposed c�radinq chan9e5 <br />• ExislmU antl proposed utilAies • Sho�v measurements <br />Phone <br />� PERMIT CONDITIONS <br />�'� � 1. All calls for inspeclion shall he made 24 hrs. in advance • phone 259•8810. <br />�= 2. All work shall be pedormed in accordance with lhis permit and wrrent City ol Everetl Design and Construction <br />Standards antl Specifications. <br />3. Call location Underground Service 48 hrs. before you dic�. TOLL FREE NUMBER 1•800•424•5555. <br />__ <br />i =-' <br />� �.� �y�� <br />%?7�7E',�'iAC <br />�fGZ i9i'JO <br />=v' cA,-cfr .B,�s„� <br />cS'e-�'i9.cif'12^..¢. /�F-1 <br />5�/O , <br />l2'�%i/ �o,9T9B� <br />CITy .S�i.9.vDS'.cO.S <br />s%�,9�.�-��✓G L G% S.l�'G � �� �?F�v�-p Ldi7�/ �'�ii•indM U� <br />a��of^ C�9sS 'b� � fJJ.��,S!9�i d//c/l i��� OF C/lUSiiFv �Sd�F9lin'C� <br />n,e PAir.t�.do Lor CqA/ 8� /�y�;�D GvrTi/ CO•�G2.�rE <br />���iii/! ���� ��' i�%� � �.. � <br />ri-�.. /f':-�� -.1:_ti�;i�- -,f � ,..�.i..� " <br />����� .�/ /S� <br />Approved lor Cons� � n � Datc <br />.�lY.� �"�"v � -� 3- .f� <br />fINAL INSF'ECTION �� <br />Approvetl as Con5lrucled <br />eveiel( PUBLIC WORKS DEPARTMENT <br />� 3200 Cedar Street <br />Everet6 WA 9820t <br />Phone: 259�8810 <br />W <br />� <br />V♦ <br />� . _Sic�.V '�� f"�': -' -i.�:^._�/,,,,i , i � . <br />. i�� / �. :� ..L:i- i,. i'<'<�- 1; ' - � . . <br />` ' ' ` ACKNOWLEDGEMENT OF CONDITIONS� � <br />The undersic�netl owner/appli[an( hereby agrees to hold antl save h:u m- <br />less Ihe Cily ot Everetl Irum any and all claims �or damogea cosu: <br />expenses. or causes of action Ihat �ay arise Uecause ol inst�ll;u�on <br />and maintenante oi the improvemeAt or other righl-obway usr heretn <br />appGed for a luriher ag�ees lo �emove same upon notice �.om Ihc <br />Ci1y and to place p�Uhc prflpe� Aamaged thereby. <br />I��' /� % .��`; `-- �'. �`, F% <br />Si �atwe�plica�( ' �ate <br />W�RK AUTHORIZED BV THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERAIIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGENTLV PURSU[D TO COMPLETION. THIS PERAt1T t.1Av H[. <br />CANCGLLED BY THE CITV UPON ANY STOPPAGE OF WORK ON 11{IS <br />PROJECT OV[R 90 DAVS DURATION. <br />