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_.,,,_ <br /> � � � <br /> � re <br /> ��� x <br /> � H <br /> Ey H f/� � �.�_ ' � _ .'.3" ^.I. v�.r'.�•:..��.v...��„i. �)I �`" )lt <br /> H �� �31C� � e�n�io�ni..�1�L1��1�-- . <br /> K y � qpplica�ion Por __ <br /> OyH PUBLCC WORKS PERMIT °°°To,aF�a`°° $ <br /> � O["� Lrfs�oc�.Poe Vmu 5_ ^ <br /> 3 oam�«o�o S ci C� <br /> y d Print or Type Only TO PQST�NG_ '� ',� ��� �l �l <br /> � � g <br /> "" " � ]� 9�'020 33�1— l.5 33 <br /> zH fr�c. J�co �sc�n i2� .Si�nsE�-� ��� Lclmon� � <br /> ,�,� y� Owner Mailing Atltlress City Zip Phone <br /> HH <br /> �N <br /> H <br /> b y qpplicant Mailinq Address City Zip Phone <br /> �� � 7 ^ � `" ' <br /> y p y Describe Proposed Work � � � r� �'C�Vr I �.�J�� � � " �C' � -� <br /> _ � <br /> - - /�� �- � y z - F_ <br /> Project Address lil knownl �`3� L Np �IZ.SL. <br /> Attach lour(4)copies o�plans lor proposed work� Draw to scale anA note Ne Pollowm9 as applica6le: � <br /> • Properry Lines • Centerline ol streel 'A <br /> • Outline and dimm�sions ot all eKistin9 and • Indicate North N� <br /> propoSeA simr.twes an Ihe lot • Show any proposed 9radinci changes <br /> • Eais�in9 and pmpased utilitiec • Show measuremenls M , <br /> '����f DO NOT WRITE OELOW THIS LWE W � <br /> / ' O i <br /> I ��1 p[RA1ITCONDITIONS �I <br /> �► 1.AII calls lor inspection shall be made 24 hrs.in advance-phone 259•8810. � , <br /> L'.All work shall be peAormed in accordance with�his permi�antl cu�rent Ciiy of Everelt�esigr�anC Consin�ction <br /> 1 ' StandardsandSpecilications <br /> '`_ 3.Gall Location Underground Service 48 hrs.belore you dig TOLL FHEE NUMBER 1-800•424•5555. � � <br /> �� �i . Ti� �l rnrl crr ..:-'t�� tion rnl �i -'� I Ic�irl I � ,'� . �,�.. � . . <br /> .� ��� � �� .� . �a �� � � � � ,�,�, , ,,� , . � ,�� �, � � � � , � , �� �� �� o <br /> r��-,u���_,.���-. <br /> ' . Keep r.ity,ystreei:s clean at all t.i.mes � <br /> � �,s r�. Curb qutter and s.idewal.k. .in thr� plat are new and undamaqi��i � <br /> ' anv dame�ue thereF.0 shall be replaced at the discret.i.on oi �� � J_ <br /> P�iblic LJorl�.s Inspector. �%d <br /> ' �-. F1ny channF= in the drivewav o�t must be approved bi the Fi�'r, � � � � ' <br /> . �1� Wor6:s Snspecter, <br /> -_ . Tiqhtli.ne all rnor, yard ard drivewaV drains to storm dr-.n-�, � <br /> stubs at back si.de c�1- sidewa:b... <br /> � - Hd.ii.isi� water bo>:i�.=_ to qr-ade at end �t r'on��t � �ict,.on . <br /> � ��� � � . L'�-ivewTYs shal ] b� {�av�d from bac4: eJqc nf id�a�all '� �nii.�� �n�..�a: ���� <br /> � , <br /> � ,� „ 1 i.nPn lC'- — i.{ {.: r�nr�,a��-.i�,rL•il !�li��.: l „ril� ir��. .li i . .�.i:,�:� i i,.=�: .��I . <br /> , ACKNOWLEDGEMENT OF CONDITIONS <br /> Thc undcrsiyned owncr/apPlicant hereUy a9rees to holA and sace hann- <br /> � - less Ihe Gty ol Everelt Lom any and all daims for damaqea �.osr�. <br /> �"� expenses, or causes ol aclion ihat may arise becausc of inslall.�lior. <br /> �� (� ,�C � _1 '7_ � i and mainlenanca of Ihe improvement ar olher riqlibol�way usr I�nirie <br /> �-'�'��� �� L � applied lur antl luriher ogrees to removo same upon not�cc hoin Ih�� <br /> _L���_ <br /> Approved for Consirudion �11e City and l/o replace public property dama9ed Uiereby. <br /> � U�� � � ' <br /> .r�//f_ 5 5��' � <br /> FIN�L INSPECTION � Date <br /> Approved as Construc�ed Signaluru oi Applicai ��'�O <br /> �� WORK AUfHORIZED BY THIS PERMIT MUST BE STARTED WI14nN <br /> PUBLICWORKSDEPARTMENT 180 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTER IS TO <br /> � 3200CcdarStree� 6E O�UGENTLY PURSUED 10 COMPL[TION. THIS PERMR tdA1' B[ <br /> Fvc�elt.V✓A 9E3201 i, ('„NCGLLED[3�TN[CRY UPON ANV STOPPAGE OF WORK ON THIS <br /> Pnonr.'�5 t3t710 � PHOJEGT OVEfi 90 [7,1Y5 L7U�7���ION <br />