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Date�/�/� <br />AOP!�Cnl�Ott FOr <br />PUBLIC WORKS <br />Print or Type Only <br />PERMIT <br />L. <br />\ <br />� ��; <br />ll ) ? � � n�'j . <br />�� a ��,,� <br />,, <br />u `± r j-l�!/ � <br />.+ 6� r% <br />Ownr,� �, ., - , q . rr3sy U� [m � � •� ,. T�n Phnnc <br />1.�•, �3 c• S n taJ �� <br />o��o�-p� <br />Q�r�����ZdS � ��� `�/ 9v��v ��� �.v� _�z�� -- <br />Apphr,ant �;..dr�::Addn•« / ':n: Z�P Phnn., <br />�� <br />Describc Pronos1rA 1M1brk =� G'�2_—'*�'"��. <br />--6—QL-/ ' - —_ _ . .______ <br />� �, �,:�,.,,. �,. ���3�C� / <br />6�no oaoi • <br />��c1Vo��6Fee 5 <br />iclai cre <br />�� <nLi r�.. Va�u S �� <br />��...�., s2�— <br />Q/u�n <br />5�� <br />�-yj<�`t�-� ------ <br />Pralecl Address Id known! �(.�.L_�—__� � ���.. � --� `G`� <br />At�aeh IOut (41 coP�es ol plans fni V�nno��ed v.o�� - D�a�•. t;� _,i��. .,:�.i ;n.L� n���'G!�::�ny i, ;�r,pLrabh• <br />• Prnperty lines <br />• Oulline flntl tlimensions o� all exis:inq a��d <br />propo5ed S�ructure5 on Ihe Iol <br />• Exis�ino and proposed utilAies <br />DO <br />. a.�,,.,���,� �,� t;,�v, <br />• Irqi�.�Pt NOrih <br />• �'Ict:' lny R[OP052A qfad�nri ah.9n�o� <br />� tif�per mn,l5ureinrni'S <br />� <br />PERMIT CONDITIONS <br />1. All calls for inspection shall be made 24 hrs. in advance- phone 259•8810. <br />2. All work shall be pedormed in acwrdance with this permit and curmnt City of Everett Design and Construction <br />Standards and Specilications. <br />3. Call Location Underground Service 4A hrs. betore you Aig. TOLL FREE NUMBER i•800•424•555b. <br />1. Inct;�l rock cousliuc(ion entrance as per cily staudard #i208 and erosion control as directed bV YubGc Wotks <br />L�spettm. <br />5. Kecp ciry shcets clenn at all times. <br />ti. Listell erosion conttol as dirccted by FubGc Works oispector in die field. <br />?. Pcmut is lor cica�iug and �ubbuig onh• - uu_gtulit�. <br />F(INAL INSPECTION L�/ L-�'- / <br />Approved as Const�ucted <br />�PUBLIC WOPKS DEPARTMENT <br />� 3200 Cedar Street <br />Evere�t, WA 98201 <br />Phone�.259�8810 <br />ACK�JO\'1LEDGC'.1f.NT OF CONDITIONS <br />W <br />� <br />N <br />� <br />O <br />,�A <br />V♦ <br />V <br />a <br />i hn unhri��;7netl owner-apniicant he�cby agrees �o hold and 5flve hflim� <br />—�� less Ihe i.dy o� Everell fiom any and all Caims lor tlamages. r,osls <br />/� �, Cx�enSEdS' O� C0u5e5 0� dC�iOn ihai mey a�i59 beCalise ol inSlBll��iDr <br />(/�` /'�� � and maintenanr,e o! �he imorovemenl or other nyhPol�way us�- ����rvin <br />�_J � L. �� �i ,�pp�ind lor and furiht'r aqrees to remove samo upon noUce ��nm II�e <br />� � L':;�� I C'� .�i�d In_iePlnce qubLc -��nerty damaged lherebY- <br />/-1 � � <br />re ol Apphcant <br />fJat�� � <br />1,'ORK 11UiH(IRIZED BV THIS'PERMtT MUST BE STARTED WITHIN <br />190 DAYS OF pATC PERG9IT IS ISSUED AND THEREArTER IS T(� <br />E3E DILIGCNTL�' � UR UFG'O C041PLETION THIS PEPt,�1T t.1l.v [3! <br />GANCELL". :-: '` l,IIY . v'Jv'�lOrPnG6 ^F l �rK r�r; ����:, <br />PRO,I[Gii%�-i�, �:��'qYSC�I�..,-,lin:d <br />