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u <br />�CMr�/� aPP�ication For <br />PUBLIC WORKS PERMIT <br />PUBLIC WORKS DEPARTMENT <br />3200 Cedar Street <br />Everett, WA 98201 (425) 257-8810 <br />TYPE OR PRiNT ONLY <br />O�rd �D� <br />Owner <br />Applicant <br />Desr,ribe Proposed Work <br />TO POSTING <br />Mailing <br />Mailing Addross <br />PROJECT ADDRESS (if known) 34� i <br />MAR 2 8 2000 <br />(Nicy � I �Y Vi�A <br />� ary <br />k:Y ��%�. <br />Da�e �/'Z/"1"� <br />Public Works Permit N —I"� <br />Building Permit N ( � �/"1"" 3 <br />Public Works Fee $ 10 ^ _ <br />Zip Phone <br />Anach four (4) copies plans lor proposed work - Draw to scale and note the following il applicable: <br />• Propeny Lines • Outline and dimonsions of all existing and propesed slructures on tho lot • Existing antl proposed utililies <br />• Centedine of slreet • Indicate North • Show any propo:ed grading changes • Show measumments <br />DO NOT WRITE BELOW THIS LINE <br />72• <br />PERMIT CONDITIONS: <br />t. AII calis for inspection shall be made 24 hours in advance - phone (425) 257-8810 <br />2. All work shall be peAormed in accordance with ihis permit and current City oi Everett Design and <br />Construction Standards and Specitications. , <br />3. Call Location Underground Service 48 hrs. belore you dig. T!;�L FREE NUMBER 1-800-424-5555. <br />�'� �lPcjl�►�F 5i�e hGw�.✓ -�p �"pvc (aP,,� Gi� 5�d �l�r� �6� I <br />i i r <br />�'7 N�v �"rkt�' �rc� wt,JS� %x P��` �v�de ��(� (�ti✓I <br />w�� y�ts �� � ��d ��ld'c�nnc�£ -f� hi�escwe% <br />�r <br />W <br />� <br />� <br />Y/ <br />� <br />� <br />� <br />� <br />O <br />� <br />V / <br />� <br />a <br />ACKNOWLEDGEMENT OF CONDITIONS <br />Tho undersigned own ' rees to hold and save harmless <br />the City of E�v rom any and all claims for ages, cosls, expenses, or <br />causes ScUon that ay arise because of install 'on and maintenance of Me <br />im vement or o r nghtv hereto I lor and further agrees to <br />move sarp� up notice om �� r public prop� dami^ <br />aged thrxby. <br />WORK AUTFpR�D BY THIS PERMR MUST 8E STAHTED WfT}iIN 1B0 DAYS OF DATE PERMIT IS IS;'�l1ED AND THEREAF'fER IS TO BE DILIGENILY PURSUED TO <br />COt::PLEf10N. THIS PERMR MNY BE CNJCEU.ED BY THE CfTY UPON ANY STOPPAGE OF WOPo( qJ THIS PROJECTOVER 90 DAYS W R4T10N. <br />