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Date � 7 � <br />Aoplir.ahcn For <br />PUBLIC WORK�► PERMIT= <br />Prinl or Type Only <br />p r�r�Cl <br />�. �� I� � O Vl <br />� r_� m <br />, <br />P��oim Wo�ws vormn . —( �/`I'� _ <br />o�eq Der� . _ . __ <br />PublifWOrM6f✓P � � <br />TOIAI Cpp S <br />U•-as Oppl [nr n'f .�1�����)���)� <br />..��.i�. �..� S LJ.I <br />� S� b <br />>r� �" }��w� ser. l�a-s— � _��—_1�1��1_ � 397 <br />Ocmci �� �� �,�nr„ .b:r, .., :i ch ' .. , t�i„ ��� <br />� � ' : i i <br />� r� r.; ; ,' t,' <br />� . ('. ._ o< ��- - <br />.� Y n� In �.� r <br />� ....______ .__ . _�. _ ____..—..____. <br />.___ _ ...__ _. .. <br />ApphCenf q.,:.. rk:i.�ss ..�.. L�n pl•��n.. ..-_ <br />DescribePionos��dlt�orN _ �1pN1,pS.r'J�'.Gi.Fr+ _�___ rs� V _�A�_� � ___ �'�-o� <br />4 S �Q���. Oed � <br />f- --- __ ,/^�-b __s _ _ _ I-, <br />Proleci Address Id knnwc� =.1I I � — � 1_ _ �-. . . NV 4 � C�Y�__ �1�___ _ <br />—__ ) _ <br />At�aeh �Our M1il eOP�eS 0� Uians loi P�onosu�l r:u•e Dia��. r.� �� .��.�.i r,. �•J�s� 'u:-�,::inG as ar ,ilir.ah�e <br />• Prpperty LinCS � G�„�h,rlinr nl cir�•�� <br />• Ouiline and dimensions u� all e•istin� anrl • I��r,��,-ab: North <br />proposetl slructures on U�e ioi •"��ov: any cronosed nrnr,�„�� r.nan�rs <br />• Eristinq and proposed utiliiies • Shnv+ n+aasureinents <br />PERMIT CONDITIONS <br />1. Ali calis for inspaction shall be matle 24 hrs. in ativance - phone 259•I38�0. <br />2. All work shall be periormed in accordanca with Ihis permit and current City of Everett Design and Construction <br />Slandards and Specilica�ions. <br />3. Call Location Underground Service 48 hrs. belore you dig. TOLL FREE NUMBER 1•S00•424•5555. <br />�. P.�►- ���r <br />ACKNO�'JLE�GEI.1ENT OF CONDITIONS <br />W <br />� <br />� <br />N <br />Z <br />O <br />F- <br />� <br />O <br />a <br />i!n� �. �id•�i�iqned ownrr/applic, ni heieby agreeSlD hold anG sace hr�� m� <br />-- — , �� �., hu Gty o� Evr�rett trom any and all claims �or tlama9es. costs <br />� i� ��ses. or causcs of achon Ihat may aris9 because o� inslallation <br />�� � �� � �nd nininnanre n� I��c imU�ovement or olher nqhl-oFway use hw�elo <br />�Z� ,i; � i ��r :inr' h ih��r aq��-e .� tu iemove sam�� upon nolice hom �he <br />Ap oveA 1 �/uur,�ion —� - � Uaf� � �. „� �� :>i , i, d��l�,: ��� �.r����y drom�ged ihereby. <br />i /% <br />fi� /v• d� �'L ' (,�/ / p <br />FIN�ECTION / Dn'c I . � "7 �I `� <br />Approved as Conshucted � Sian. Ime ol nD ����' Oa;e <br />�F'UBLICWnRKSDEPARTMENT I 11'ORK dUiHO IZF:O 8'I T PER."dIT A4UST BE STARTED WITHIN <br />�_� �HO DAYS OF DATE PEFIdIT IS ISSU[D AND TH[RE�FTER IS TO <br />/vf 3200Ceda: Street I pE DILIGENTLI' PURSUED TO COh1PL[TION. THIS PERMIT 1.1AV B[ <br />� Everelt, WA 98201 � <br />'-��'10ElLG_ F'� Tn� GITV U�'t:iN ANt� �TOPPAGF OF WORK ON � HIS <br />Phone-259-6810 � PqrJJEC,i i;YCli _f0 UAYS DUV;,1110�: <br />