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� PUBLIC WO KR S PERMIT <br />PUBLJC VYOIiI(8 06Y1R�Bi[ <br />3I00 C�dr SUsst <br />WA 259-el10 <br />TO POStIN�' - �-- <br />TYPE OR PRINT ONLY <br />��gSo�or-000 <br />O ON O 3 U7 <br />Lou Urrutia 1OS31 59th A�ir��'. �ii.tio 4��� <br />✓ <br />�. �—�-9r <br />P�bBe Nblm PemYt � J [�� <br />� �. sse� <br />wen� v�an�e F« s ZO _ <br />OWf1Bf �(g� ri CN.,.-� r� ¢ � q10fIB <br />�.� <br />Describe Proposed Work new <br />PROJECT ADDRESS (if krrown) <br />620 Ross <br />Lot 3 SP M37-96 <br />Attech four (0) coplse of p,,,ns ror PmPosed woric - oraw eo scw and na. me roiawin� rc ap�wceeie: <br />RropeAy IJnes �Outline ond dknensions of all exhtinp eM poposed M�ucturee on the bt �Ezbtlrp and popossd ��tiNtbs <br />`Centerline a atroN 'Indkste Nortn 5how any Wopoaed pWkq changes 'Slaw measurert�enta <br />PERMIT CONDITIONS: <br />1. All calls fw inspection shall be made 24 hours in advance - phone 253-8810. <br />2. All worlc shall be perfamed in accordance with this perrnit anti cunant City ot Everett Design and <br />Construction Standards and Speciflcatlons. <br />3. Cell Location Underground Service 48 hrs. before ycw dig. TQLL FREE NUMSER 1-800-424-6666. <br />=-{ � 1 w�fw�f t� rd�,,,-kz�l �an� KU.►- syr�•�. ,�-.� iv� �A ��' 13p, <br />S f��vp �of�-� .;ti,-F� (�� 5y�� �r o�fc.� s-�-Js, <br />(� �-��d ��. zy�3 �e <br />�G)(/�M�2i �i �i/� � i��T^'�G� (Z$dl'�O <br />Trerc�b, ��� L x 3�� x3 `c�l <br />ACKNOYVLEDOEMENT OF (�NDR10N3 <br />The underaigned ownedepplkant hereby eprsa b MM and eeve harn�leea <br />the City oi Everett fiom any end all clahns ta Arnqr, cosb, expensea, a <br />causes or ac+bn �net may aN�e bece�,ae a wissr.uon .na meh,cenanw a <br />tha improverrbnt or otherripht-of•wey uae Iwrto appftl laand hxlher apesa <br />to rertrove aame upon notlee fiom the Gty arW lo iepl�ce P�� W'oP�Y <br />dama9edth�ebY• <br />� <br />Sipnetu�e of DMe <br />WORK AUTHORIZED BY THIS PERMR MUST BE STAR'TED WITHIN 180 DAYS OF DATE PERMR IS ISSUW AND T}IEHFA IS TO BE qLIOENiLY PURSUED TO <br />COMPLETION. THIS PERMIT MAY BE CANCELLED BY THE CfTY UPON ANY STOPR�GE OF WORK ON i}d$ PfiOJECT OV9i YO DAYS DURIITION. <br />rr <br />