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Date 6-23-93 .��.tw�..,o.,m,�._ <br />AO�licalion Fcr umo o.m . �]�$1 -- <br />PUBLIC WORKS PERMIT °°°,o:.:'•• s <br />�...+enm r.. v.a S _ <br />e.n ao�. S <br />Prin1 or Type Only <br />Glen Serl 4614 S 3rd Ave Everett WA 98207 743-I555 <br />Owner Matliny hdtlress Gity 2ip Phone <br />Tovn 6 Cauntry I6521 Ilwy 99 Lynnwood Y8036 743-1555 iroy Olxon <br />ApPhcant �dailing AOO�tss Gty ZID Phone <br />Desciioa P�oposee Work nev Fetege <br />Prolec� Adtlress �il knownl 4614 S 3rd Ave <br />AIIazP low I<I �omes oi plans lor pro0osed woih � Draw �c scalp Tne nole I <br />• PmcerryLlneS � <br />• Oulline and dimensions o� all eust�nq antl • <br />ptOPO5C4 S�NCWIPS On �M1C 101 • <br />• Lus�ing an0 pmposed uliiilres • <br />DO NOI WRIiE 6ELOW <br />INITiAL �NSPECTIOh <br />KIRK BROOKS <br />G ��;• ;. <br />o�Te ------�— � <br />q /� V <br />!WO 1'�� �u���•� <br />/ <br />PERMITCONDITIONS '������^' 7 <br />1. Ap �+IIs lo� Ins0eC0on shall W! maEe ^.4 hrs. in advence � p��onC I—� � Y <br />2. All wurk shall �e pedOrmeE in acrnr�ance witn Ihls p?rmil nntl c <br />StanQartl6 end SpC[i�ica0an5. <br />9. Csll Location UnEergmund Service c8 �rs. hcloie you d�{� TOLL FREE NUMBEN 1•80�-424-$555. <br />PUBLIC WORKS PERMIT <br />NOT REOUIR[D <br />EV �� <br />DAT� <br />Appiove0lorConStruciion Dcte <br />FlNAI INSPECTION Date <br />Approved xs Conc�mcleA <br />�PUBLICWORKSOEPARTMENT <br />3d00 Ceder Street <br />Eerell. WA 98201 <br />Pnone'Y59-9fl10 <br />HGHNOWL[DGUdENi OF GONDIiIONS <br />Z <br />O <br />H <br />� <br />O <br />a <br />l lic un�ni siynrtl ownei/apPlicani hcrc�y agrees lo hola anE save M1arm� <br />IMS ihP Gly OI F.aMP,II IfOrtl AOy dPd dll CIdiIPS IOf Gamagca cosls. <br />C�pC�SC6 OI Cd115C9 O� a[tion ihal may anse bCC344C OI VlSidllB�i[llt <br />and mainlenxnce ol �he imp�ovemeni or ol�er ng9Pobway use herelo <br />tpphM for antl lur��ei agrees lo iemove same upon nolme Irom I�e <br />Cily and to replace public pmpeity tlamaBPd ibe�e5y. <br />$Igneture ol qppl¢, nl Uaie <br />WORN AUTHOHIZED BY iH15 PERMIT MUST BE STAfiTED WIiMIN <br />IBO DAVS OF DATH PERMIT IS ISSUED AND THERE�PTER IS 10 <br />BE OILIGENT�Y PURSUE� TO COMPLETION TMIS PERMIT MAY A[ <br />GANCELLEU BV iHE CITV UPON FNY STOPPAGE OF WCAK ON iM15 <br />PROJEGT OVE� 90 DAYS DURATION. <br />