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/ : <br /> / <br /> �ate�'� P,���,�wo���Pe,m,�. %b�'q'� - <br /> �� Application FOr eiag.Deoi.+ _ <br /> PUB�.IC WORKS PERMIT PUOTOTiFea`e� 5 <br /> U <br /> rJ LessRp01 Fe•Pa�d � <br /> a O O Bdlance Duc $ 2�� <br /> Print or Type Only w � � — <br /> o i:, o, <br /> �n .w <br /> r•�� 7 74— o Z z'3 <br /> ��+ '� �,,aist��.,tv Y�9o2 —3�5�' t�E • �lL���a3 �' :3 5�b_— R4-35" <br /> Owner ��� r?a� :: Mailing Address Cdy Z�p Fhene <br /> o r� � <br /> /( � �� odN'. 1 r �L � �� <br /> � nr_i <br /> Applicant Mailing Address City Zip Phc�e <br /> Describe Proposed W�rk nL �-N-��6C l OF� �'�_�v� Sk=11y�' /(��S�r=S�4�• __ <br /> S�L� ����/J �{'�a.'I.Lrr ___"_—_.____ __ <br /> � � ? ���lfl�-�_5�-- ------ W <br /> 32i� Av� SL � �-o� S p 1227F! 5�. � <br /> Project Atldress(if known) __ _� _._ <br /> Attach tow�4)copies ol plans la proposed work- Oraw to scale and note the foilc�v�ng as aFPlicahle � <br /> • Property Lines • Genterfn=ol slreet /w <br /> • Outline and dimensions ol all existin9 and • Ind�cate Noi�h V, <br /> proposed siructures on Ihe lot • Shov:anv proposed grading changes <br /> • Ezistinq antl proposed utilities �� Show m=as�rements � <br /> DO NOT WRITE BELOW�:HIS LINE <br /> PERMIT CONDITIONS O <br /> 1.All calis for inspection snall l e mede 24 hrs.in advance•nnone 259•8810. � <br /> 2.A'I work shell be pedamed in accordance with Piis permit 2nd current Ciry of Everett Design and:onsiruction <br /> StanEards and Specifications. <br /> 3.Call Location Underground Service 48 hrs.before you dig.TOLL FRE1i NUMBER 7•800•424•5555. � <br /> 4� AC�PL.i LA1�LT SHRI..L �R-antr �TO"'C�� ��TY o F ��"TQ� .�. O <br /> ZO �d`JT EASEvjE�..11' ALCN6 Z-61E 1�'APElZ7"'�ES 'F20�.TTDYL'� <br /> oN 3e-D �- sc �ee -�ttc— Pu�cPOSc �.�� eoadw�t �-� � <br /> V71 L.1 TIES. ♦/� <br /> ♦/♦ <br /> O <br /> � <br /> ACKNOWLi:DGEMENT OF CONDITIONS <br /> i� The undersigned owner/apFlicant hereby agrees to hold and sace harm� <br /> c. �O less Ihe City of EvereQ Irom any and all claims lor damages. costs. <br /> p expenses, or causes of acticn that may arise because ol inslallation <br /> ���� � �� UO and aintenance ol lhe imprcvement or other righ4of-way use hereto <br /> � — ap ed lor and further agrees to remove same upon notice irom Ihe <br /> Approved Constructi n Uale nd lo replace public propeity damaged therei+y. <br /> A � � � _ _ <br /> /' <br /> � ��_ ' g Q �p <br /> FI ALI ECTI N -�� f Date ' <br /> App�ovnd as Constiucted e ol Applicant ate <br /> everett PUBLIC WORKSC �',iMENT O THORIZED BY THIS PERMIT MUST BE STARiED lVI7HIN <br /> � 100 AY OF DATE PERMIT iS ISSUED AND THEREAFTER IS TO <br /> 3200 CedarStree' BE DILIGENTLY PURBUED TO COMPLETION. THIS PERh11T �-`Y 9fl <br /> Everett.WA9B20' CANCELLED BY iHE CITY UPOPJ NIJY STOPPAGE OF WORK C THIS <br /> Phone:259�BB10 PROJECT OVER 90 DAYS DURATION. <br />