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- I<-5-2�-5 ����3t�-r -, <br />D3lB 9I1JI91 �... ��encwmksaai,n. <br />emo osoi • — 91/27753 <br />npplicotion For ppST � 7� <br />� E�NIITING /_ 9z <br />PUBLIC WORKS P °"�"`"'°'""�`° _ <br />,o�,� �a< <br />�es� noo� ren ania S <br />� _. . -�� , :� � :-� eaixnceouo $ Z'c7 <br />- '�.. .., � 1 fJ'-� <br />PriM or Type Only - ' : , �, o �,' , �, .. , � , r <br />� � , r, u� n n ��i �i ��: <br />.n r <br />i � M 4T � Jl ai �� CI <br />Uavid Pardue 5802 S 2nd Ave Everett �98$48 258-1404 � <br />— Mailing'Addr�s..-� �° '> � Ciry � �_� -_ � Zip Phone <br />OWPCI ' o.l ii-'-� `. ra c9 m T 'v_ t: r.J <br />ri �ii Ci �ii i— .r C - U) � li.l <br />PI O r- Gl .1 Cl C� f� U�': U <br />C� .� .� �.� :: _� Y� J. I bJ J = Jf <br />__ -... ..,.,.J.-mo_r_ �. mo[.i <br />Describc Proposed Work <br />Projecl Address lil known) <br />Mailing <br />— S. ZN17 <br />Zip Phone <br />Attach lour 14) copie.s ol plans lor proposed work - Draw to scale and note Ihe lollowing as applicable: <br />• Properry Lines • Centerline of slreet <br />• Outline and dimensions ol all existing and • Indiwte Norih <br />proposed structures on Ihe lot • Show any proposed 9raoing changes <br />• Existing antl proposed utilities • Show measurements <br />PEflMIT CONDITIONS <br />7. All calls lor inspection shall be made 24 hrs. in ativanco � phone 259•5810. <br />2. NI work shall be pedormed in accordance with lhis permil and current Ciry ol Everett Design antl Constmclion <br />Standards and Specilications. <br />3. Call Location Underground Service 48 hrs. belore you dig. TOL1. FREE NUMBER 1•800•4•24•5555. <br />�1 1 ir' �t/�wa.� e1� vd 6:cn ai, J�o�� �= lU` �ves� �-,{- <'>: iS�_�n� <br />, <br />f`Occ�v�v�- �dc�C 0� f�VCrv�e'�� <br />�� L,r,�s-��� E�.L�O� ��a�i-:1"`t�rl�. <br />�cu.�Q, I'V� ` l�e1z_ I v- 3- 9 � <br />Approvetl for Conslr c�iGn Dale — <br />l�: - �— 3 - 3 - ) z- <br />FINAL INSPECTION �atc <br />Approved as Consiructed <br />� l PUBLIC WORKS DFPARTMF.NT <br />�Vr� 3200 Cedar Stren.t <br />Everett WA �30207 <br />Phone: 259�df710 <br />� <br />to `�c no h;��i�e.;• Lha,, �he. <br />� <br />O <br />�w <br />�I <br />0 <br />a <br />ACHNOWLEDGEMENT Of CONDITIONS <br />The und?rsi9ned owner/applicant hcmby agrees �o hold and save harm� <br />less ihe City of Evereil ��o� any anA all claims for dama9e5. .:osis. <br />ezpenses, or causes of action Ihal m�y arise because of installation <br />2nd maiNenance ol Ihe improvement or olher righ��of-viay use hercto <br />applied lor and lurther agrees lo remove same upon notice Irom Ihe <br />City and to reRlace pu6lic p�oPerly damaged there6y. <br />G ( ��.�U t/� <br />Si�natV ol App icani Dalc <br />WOR AUTHORIZ[0 BY THIS PERMIT MUST BE STARTED WITHIN <br />180 DAYS OF DATE PERMITISISSUED AND THEREAFTERIS TO <br />BE DILIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAY BE <br />CANCELLED BY THE GTY UPON ANY STOPPAGE OF WORK ON THIS <br />PRGJECT OVER 90 DAYS DURATION. <br />