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Datr 3/5/91 <br />� Applita�ion For <br />PUBLIC WORKS PERMIT <br />Print or Type Only <br />Pub'�r. Wo�hs Permn . �j � /�" <br />om9 ocoi + 91/26573 _. _ <br />PubLCWarkSFce $ <br />Tola� fee <br />Le55 App'. Fc¢ Paid 5 ^ <br />Bnlance Oue S �� <br />.Pic��d '/�3 <br />Phone <br />ny �dtlress <br />Applican� <br />Describe Proposed Work �nstruct new dZd E at SFR <br />P�ojecl Address lil known) <br />City 2ip <br />Attach lour 141 copies ol plans br proposed work - Draw to scale antl note � Cen'terline ot stree�cable: <br />• Froperty Lines • Indicale North <br />• Outline and dimensions ol all ezisting and � �how any n�oposed grading changes <br />proposed sirudures on Ihe lol • Show measurements <br />• Exis�ing and p�oPosed utilities <br />PERMIT CONDITIONS <br />t, All calls for inspection shall be made 24 hrs. in advance- phone 259•8810. <br />2. All work shall oe peAormed in accordance wilh lhis permit and current City ot Everelt Oesign and Construction <br />Standards and Specilicati�ns. <br />3. Call Location Undergrour�d Service 48 hrs. betore you dig. TOLL FREE NUMBER 1•800•424-5555. <br />[� C "' � c✓aes ho7`' a��e4� 7`o L;%,c �-� <br />GXisfin� �r.vrw.cj/ <br />Ic��15� �rn��,s�•r' y'"i'a�j e_ J�s a4 �G ne�✓ �i-�.ve.��.�/ <br />d f,�.- c.>y sf�., d�,-d �`.�o� <br />Cv/'6 cc.7` 4�� /'�.� vi� c P 6 L: c <br />�CnPf/ Ql%`a c�e <br />/'e$vesf �c¢!.".�y t�ii`/, v t✓nrks <br />" c.�or LiF ciniri� 1�.�.�-�ti,�j/ [v[�rif' �cp�-c'��ffacle�J <br />/i7S�t. <br />o�Y <br />� �i�/ O�'�" <br />Approved lor Conslruclian <br />FINAL INSPECTION <br />Approved as Constructed <br />everetl PU6LIC WORKS DEPARTMENT <br />� 3200 Cedar Street <br />Everett. WA 98201 <br />Phone�.259-8010 <br />(� � til� � 1� - ���. � a-< < <br />�� � �� � <br />,\ V_ � l��ii G� lG\� r�..y �� { � CJ � �� <br />I I <br />—�— ��C� r e. ( cL�z � � � - — <br />. V (<�� ��/'_. C,/7 Z- <br />� <br />O <br />�"' <br />N <br />O <br />a <br />�.., r.a�m� <br />)es, cosis. <br />nstallat�on <br />ise hereto <br />) hom Iho <br />Da�c <br />D WITHIN <br />[R IS TO <br />T MAY L�[ <br />K ON THIti <br />:fw:'-.. �� <br />