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Uate__a�(�$Cf <br />� <br />Applicaticn �or <br />PUBLIC WORKS PERMIT <br />Print or Type Oniy <br />aiting <br />MaiGng <br />Descnbe ProposPdtNOrk <br />n <br />Pro�ecl Address Ut known) fu� �Vd �� <br />Atlach lom 1�I copies ol plans lor proposed work � Draw to scale antl <br />• Property Lines <br />• Outhne and dimensions ol all exist�ng and <br />proposed 51ruCtureS on Ihe lot <br />• E•ret�ng and proposed utlhiies <br />ruhi�c Wn�hs nrimn(.��, ��J y/�' <br />tlin�l Den� � -__p_l_. pCP-�(_�. <br />�� "__—_ <br />PuLhe Wnnc�er-_"'_--""_ -- _ _" <br />tuta�rcr g-- <br />lessAnO�Fe�PeidS — <br />o.,i,��.�, n�„ a <br />Cily <br />ly uP <br />Ihe follov.incl as apulica6le: <br />• l:enterline ol streel <br />• Indicate Norih <br />• Show any proposed grading changes <br />• Show measurements <br />PhonA <br />PERMIT CONDITIONS <br />7. All calls lor inspection shall be made 24 hrs. in advance • phone 259•8810. <br />2. All work shell be performed in accordance wilh this permit and current Ci;y of Everett Design and Cons'ruction <br />Standards and Specifications. <br />3. Call Locetion Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1•800-424•5555. <br />���ll<< lL-!"!�; /::j;n��.C�.%r/ /.G.ltiG2�'�. <br />Approved 1or Construction <br />FINAL INSPECTIO� I <br />Approved as Construcled <br />everetl PUBLIC WORKS DEPARTMENT <br />� 32C0 Gedar Street <br />Everett. WA 9A201 <br />Phone: 259-tf810 <br />��✓ti �7l'�'�� <br />cg- �� 8� <br />ACKNOWLEDGEMENT OF CONDITIONS <br />� <br />O <br />� <br />� <br />O <br />a <br />The untlersigned owner/applicant hereby agrees to hold and save harm• <br />--- !ess the Ciry of Everetl Irom any and all claims br damages, cosls, <br />— I eanenses, or causes ol action Ihat may arise because of mstallation <br />and maintenance ol the improvemenl or other right-ol-way use herelo <br />applied lor and luriher agrees to remove same upon notice from ihe <br />Date Ciry and to replace public property damaged thereby. <br />Dale <br />Signature ol Apphcant "�" <br />WORK AUTfiORIZED BY THIS PERMIT MUST BE STANTEU WITHIN <br />180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br />BE DILIGrNTLY PURSUED TO COMPLETION. THIS P[RMIT MAY BL= <br />CANCELLED BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br />PROJECT OV[R 90 DAYS DURATION. <br />