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/^' � POSTING ��� ��" � i <br /> �.J APP�iwtion — . <br /> PUBLIC iNOR�S PERMIT Date ' � 13 9s <br /> PUBLIC WORKS D �,ARTMENT Public Works Permit a S <br /> sz� <br /> 3200 Cedar et <br /> Everett,WA 98201 0� 259-8810 Building Permit p <br /> TYPE OR PRINT ONLY a $ g public Works Fee$ �� n'� <br /> � � � �� <br /> i►Ji ���am �a��e 1o9zi �sj��e S� E�e�ertf' `l$oa8 3S'S�YB/�/ <br /> Owner � Mailin�7 Address a �, tpn. Ciry Zip Phone <br /> If O W [yj <br /> '" � � 6 O -`T 8'77 <br /> �ob�c� �.AnowoKKs `/So,6 �.i � �j � r»�� RSoy3 Y <br /> Applicant Mailing Address City Zip Phone <br /> DescribeProposedWork � '�'�n� E (� �� ' S'fo�rr� ,��tq�h �l�h ! „ <br /> W <br /> � —ra' i^� �i"F'4.• � <br /> � <br /> � <br /> PROJECT ADDRESS(if known) I z �r U< g� � <br /> Attach four(4)coples of plans for proposed work-Draw to scale and note lhe following if applicable: O <br /> •Property Lines •Outline and dimensions ot all existing and proposed structures on the lot •Existing and proposed utilities <br /> •Centedine of street •Indicate North •Show any proposed grading changes •Show rneasuraments � <br /> DO NOT WRITE BELOW THIS LINE <br /> PERMIT CONDITIONS: z <br /> 1.All calls for inspection shall be made 24 hours in advance- phone 259-8810. O <br /> 2.All work shall be performed in accordance with this permit and current City of Everett Design and <br /> Construction Standards and Specifications. <br /> 3. Cali Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � <br /> 7` ��iLcic�f �v �� cr.C��c�ed<<.i�� � <br /> '� /Y-/Z f i�e �!r O <br /> /Z Di�i�t�r <br /> , <br /> //IS/��G7�0'/^S �/�IS�rv c �.o/'�S <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> '��� J //�S The undersigned owner/applicant hereby agrees to hold and save harmless <br /> �� �� /SL the Ciry of Everett imm any and all claims for damages,costs,expenses,or <br /> L2'v—� causes of acllon ihat may arise because of installatio�and maintenance of <br /> qpprov IorConsiruction ' �a� theimprovementorotherright-ol-wayuseheretoappliedforandturtheragrees <br /> to remove same upon notice irom the City and to replace public property <br /> � � damaged ihereby. <br /> p(p,�t,� e �' )) ./± <br /> Approv��as i,onstructed � ���.� II'IS `7� <br /> Si ure o��Applicant Oate <br /> WORK AUTHORIZED BY THIS PERMIT MUST BE STARTED WITHIN 180 DAYS OF DATE PERMIT IS I�SUED AND THEREAFfER IS TO 8E DILIGENTLY PURSUED IO <br /> � COMPLETION.THIS PERMIT MAY BE CANCELLED BY THE CIiY UPON ANY STOPPAGE OF WORK ON THIS PROJECT OVER 90 DAYS DURATION. <br />