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Date ��L�� <br />Application Fot <br />PUBLIC WORKS PERMIi <br />PriM or Type Only <br />App!icant <br />Describe Prouosed Work <br />Prolect Adaress (if known) <br />Mailing Address <br />PueUc worxs vermn • 8$ � 03 <br />01tlp Deol • <br />����� � Wo,�, F�� S <br />,o�a� F�� <br />LessAno� FcePaia 5 <br />6alrncc Duo a <br />2ip Phone <br />Attach lour �4) copies of plans lor proposed work - Draw to scale and note the lollowing as apPGcable: <br />• Property Lines • Centerline ol sireet <br />• OWline and dimensions ol all existing and • Indicate North <br />proposed sUuctures on Ihe lot • Show any proposed grading chanye, <br />• Existing and proposed utilities • Show measc•ements <br />PERMITCONDITIONS <br />1. All calls for inspeclion shall be made 24 hrs. in advance - phone 259•8810. <br />2. �II work shall be perfo�med in accordance wi�h this permit and cunent City of Everett Desi9n and Construction <br />Standards and Specilications. <br />3. Call Localion Underground Service 48 hrs. before you dig. TOIL FREE NUMBER 1•800•424•5555. <br />/�� � /� / <br />�4LGl/{'lilG-(+.��v _e%>.l�u7"�%�lix��-e-�-�.,!/� W �� �7B <br />� //4�/ <br />�:�. <br />Approecd lor Conslruetion <br />FINAL INSPECTIOIJ <br />Approved as Constructed <br />evrreit PUBLIC WORKS DEPARTMENT <br />� 3200 Ceda� Sireet <br />[veretl. WA 98201 <br />Phonc.250-BJ10 <br />_ U.�Ic <br />D3�C <br />�iCKIJOWLEDGHA4ENT OP CONDITIONS <br />W <br />H <br />_ / <br />� <br />O <br />1 he undo�s���netl owner/apphcant hereby ayrees to hold and save na�m� <br />Icss the City ot Everelt Irom nny and all claims lor damages, costs. <br />expenses, or causes ol action Ihat may arise because of ins�allation <br />and mainlenancc o1 the nnprovemen� oi olher n9ht-of�way usc hercto <br />��PnLod �or :u�d lu���n��i ayrees to icinoee same uPon i���iir� tr�m Ihi� <br />Cit1':�n�', Iu i"plai.r Pul�lu. pinl�rilY A.ini,iqi�d Ihcicl'y <br />_�,�.qn�ilui�, i:l i1��I�hr,ini . _ _._ .—__- Dai�� <br />WURh AUTHORIILD L3Y T111S PERMII MUST OG STARTED WIiHIlV <br />180 DAYS OF DATF PERMR IS ISSU[D AND THEREAFTEH IS TO <br />8E DIUGf_NTLY PUFSUED TO C061PLETIOIJ. THIS PERMIT h1AV 6[ <br />C�NCEILED BV THE CITY UPON �Nl' STO!'P�GE OF WORK ON THIS <br />PI;OJE_CT OATN �.ln Ur.YSI�i �Rl�TIUtJ <br />