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�a <br /> �. <br /> . <br /> ��� ��� p '` TO POSTING �� <br /> iu-za -qr �q/Zsi <br /> Date���;.� r lO „�,�.�„o•��r��m /- <br /> a � i� AppliCa�ion For ��nu Dcu��� �/�J�IC-' <br /> r .�.[N'01kB fre <br /> � ' � PUBLIC WQRKS PERMIT �° ;�,a�F�� g <br /> � � ���:s nnni fre Pa�a $ —" <br /> O <br /> ��� � in o n r� o n �� r. �J :n oain���o�e 5 .Z..�^ <br /> Y- � O O :�l r: � r J :.� ��_� 1'! <br /> � PfiM Of Type Only�� i� N � �� � � r_� c� r:� �-� <br /> �-r O b: P o: ,.J �] Y. .-� lf� p.� <br /> � y7 bi al A CI� :;: �'� `l. �� <br /> �A �-� � �rt C'��--��x�_ "I�� f����� I ����0 3�l-�� <br /> � �y � iwy s^� �t i ' Ci1y Zip Phone <br /> Owner � o �� �� ��'�`3 n i,i .�+ u <br /> .-. c� r� m �� ui _, o �- oa r� rw <br /> p• � o � � ��i .r_ o ¢ owz .. x <br /> � P) 's Cil 0. � G] e_ :tl: =T -c Vl ul .-� CJ – <br /> M <br /> .�y y Appncant Mailing AdAress City Zip Phone _ , <br /> �y� ^M�� � <br /> (7 ~ V/ <br /> . r��jp Uescri6e Proposed Wark � — <br /> a <br /> ��� W � <br /> Praject Address(il knownl <br /> Cc�9 - Zr",7 02 5E. � li <br /> I <br /> A�lach four(4)copies of plans lor p�opoaed work- D�aw�o scale and note ihe Inllowiny as appLcat�le�. � ' <br /> • Properry Lines • Cenlerline of street /^ <br /> • Outline and dimensions ol all eaisting and • Indicate Noilh V� <br /> picposed structures on the lot • Sl��ow an1'Noposed giaUing changes ' <br /> � • E.15tiny and proposeo utilities • Show mcasurements /y� <br /> W <br /> ���� , DO NOT WRITE BELOW THIS LWE O � <br /> I �� PERMIT CONDITIOIdS <br /> • 1.All calls lor inspection shall be matle 24 hrs.in advance-phene 259•8870. � ,, <br /> 1 � 2.All wo�k shall be pedo�med in acrortlance with this pennil and current City ol[verctl Desig�i antl Consiruction <br /> Stendards and Speci�ications. <br /> ,`� 3.Call Location Underground Service 48 hrs.bebre you dig.TOLL FREE NUMBER 1•800•'�24•5$5S. � <br /> !�+� <br /> � 4.ANY CHANGE IN THfi DRIVEWAY CUT MUST BE APPROVED ^ <br /> � BY THE PUBLIC WORKS INSPfiCTOR. y <br /> ��� 5.CONNECT DOWNSPOUTS TO PGBLIC DRAINAGE SYSTEM. <br /> � ��� 6.KEEP CITY STREETS CLEAN AT ALL TIMES. � <br /> � 7.ANY DAMAGE TO THE CURA AND SIDEWALK WILL BE REPE�IRF.D � <br /> TO THE SATISFACTION OF THE PUBLIC WORKS DEP7'. <br /> ����� O <br /> ,�-� <br /> a <br /> � L�- ACKNONLEDGLMENT OF GUNDITIONS <br /> � � �� _ Theunr .iedownenapplicanlhcreUyagreestoholtlandsaveharm- <br /> !' � '.ess tl�. � ul [vereY Irom any and all claims for dama9es. cosis. <br /> ` �zpen -_ c�u�e; o oction that miy arisa 6ecause ol installa(ion <br /> �� p `1�IL���_ /' _ I U` (�� and m . �, � nai,ce ol Ih�• anprovement or otlier righPof-way use herelo <br /> ���- �� �R � apptim '� and lurlher a9mes to remove same upon notice frcm the <br /> Approvetl for Constructiog / Date City and Io replace puLlic properly dama9ed Ihereby. <br /> C� <br /> G '� /J/G- Gi / �G.: � /i�-'- <br /> _�.i�' / �' ��'�i � Y� <br /> FINAL WSPECTIUN Datc �---� <br /> Approved as Cons�ructed Sig ere ol Ap;:licaN ����� <br /> ORK FUTHORIZED �:' THIS PERM1!!T MUST BE STARTED WITHIN <br /> eveien PUBLICWORKSDEPARTMC-NT 1y0 DAYS OF DATE P[1'.MIT IS ISSUED AND THEREAPTER IS TO <br /> � 3200CetlarStreet pE DILIG[NTLY PUFSUED TO COMPLETION.THIS PERMIT A1AV �[ <br /> Everelt,WA 98201 C4NCELLED BY THE GTY UPON ANV STOPPAGE OF WORK ON THIS <br /> Phon2:259�6R10 PFOJECT OVER 90 DAYS DUPATION. <br /> � <br /> I <br /> i <br /> I , . <br />