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Date �'�Z �`L� <br />PUBLIC <br />Print or Type Only <br />>: <br />Appl(c�io� Fa TO POSTI N G. <br />WO�KS PERMIT <br />O <br />0 <br />O <br />� t�g�3�i�' � <br />� o�m�o 0 <br />O � M M N� N <br />�-1 �� _ �.� _ <br />MAY 1 4 1959 <br />�� <br />o r{ <br />tli m <br />N <br />.,.kw�.. ��. 9/— zZ <br />eaaw,,. 4 �(�`�T/ - <br />PuDNc Worb Fw <br />Tot�l FN i <br />LH� AOpI FN P�IU / <br />�4nnDw � ��� <br />3. 7ss3 <br />N [t � h�cy: LI <br />n` U' C] 2 ' 3 O lal CJ p Phone <br />t'� Op fJ� O'i Lt Ui � p�W O 3 W <br />1!1 3k �!] � l� f� � VJ � VJ [ 7 <br />d <br />APP���eM Msi6np qddresa Cit — <br />y Z�P Phone <br />Describe Proposed Work <br />Project Address (il known) <br />Attach lour (4) copies of plane lor proposed work - Draw to scale and �iote t�e fol�owing as applicable: <br />� Property Lines • Centerline ol street <br />• Outllne and uimensions of ell eziating and • Indicate North <br />proposetl slructures o� the lot � Show any proF�oaed pradlnp chenqea <br />• Exiatinp antl proposed utilities • Show measurements � <br />PERMIT CONDITIONS <br />1. All cells for inapection shell he made 24 hra. in edvence- phone 259�8610. <br />2. All work ehall be pertormed in accordance with thla permit and current City ot Everett Deelpn end Can�truetion <br />Standarda and SpeciHcatlone. <br />3. Ce�l Lxation Underground Service 48 hrs before you dig. TOLL FREE NUMlER 1-800�4Q4•5555. <br />s! T,.,p�Q,,�, �^eLota f.�n Of G.YiS-f•n� c�t�e CC in, S�7vL( <br />ha�' /ie wif/�in fhe �u6li� iP.,y.if-a1r Waj/. <br />�� �-� /�9�/ <br />Apprcved�or ConsiruCti^-�, Date <br />FINAL INS�ECTION <br />Appiuved ss Conshucted <br />rv���rtt � PUBLIC WORKS DEPARTMEKf <br />� 3200 Cedar Streot <br />JEverett,WA982Ut <br />Pl��one: 25&BBtO <br />Date <br />ACKNOWLEDGEMENT OF CONDITIONS <br />W <br />� <br />� <br />� <br />� <br />O <br />� <br />� <br />O <br />a <br />The undersigned owner/applicant hereby agrees to hold and save harm- <br />less the City of Everett Irom any and all claims for damages, costs, <br />ezpenses, or causes of action Ihat may arise because of installation <br />and maintenance of the improvement or other NyhhoFway use hereto <br />applied for and further egrees to remove sama upon nolice from the <br />Cit and to replace public property damaged thereby. <br />� <br />S a9�9 <br />Signatwe ol Applic n Date <br />WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS �TO <br />BE DILIGENTLV PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OVER 90 DAVS DURATION. <br />