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� (� <br /> k f <br /> ` � <br /> i <br /> � <br /> , <br /> y"� i <br /> ��� _ <br /> t"y y � <br /> ��� , <br /> �y��y 7d Date �1-14-91 ` �-� Z`� �'-'-� ��� �� ���� <br /> Q�+!0 � PuobcWo.UPeimit. J1 /"'P`i^9 . <br /> � I"1� _.._.Y_._.�_ <br /> y Applicntion Far� ema oem .�f QA1Z2 <br /> ��� PUBLIC WORKS PER�i�STING �'�a�lR�' °°°;o,.F�;�°° s — <br /> Ohtl H �y ieae nooi.fen an�a S � <br /> H t�O Print or Type Oniy �� « � � o��,��.P o,�o s ZC�— <br /> Q` � � <br /> i �iri � � � ii ''� r �� <br /> H� :., � '� �._ <br /> �W y OwnerVIN S PATTI XXX IIARTON i� PO BOX 7651 ' EVERET�f 98201 <br /> 339-8081 <br /> H Mailing Add�e56> > ? 41ty � , Z�p Phone <br /> d�p � � o �c i r --, <br /> � � � _t ri L� r i .� r r, ���f [ W <br /> APPLICANT ' j <br /> y� APPIiCant A4ailing Adtlress . � �,.. City ` ` . .f Zip Phone I <br /> O fA <br /> Uescribe Proposed Work NEW SFR � <br /> _ I <br /> _ W ', <br /> P�oject Adtlress(il known) _ JlJ�O C. V{E�y �2 � ��� ��� � <br /> Mtach lour(4)copies of plans lor proposetl work� Draw to scale antl notc the following as applicable. ' <br /> � <br /> • Property Lines • Centedine ot streel I_ <br /> • Outline and dimensions of all ezisling and • Indicate North v+ <br /> proposed.:tmctures on Ihe lot • Show any U'oposed 9radi��changes <br /> • Eaisting and proposetl utilities • S�ow measurements <br /> �� � DO NOT WqITE BELOW THIS LINE � <br /> C�, PERMIT CONDITIONS Q �' <br /> , � 1.All calls lor inspection sha�i be made 24 hrs.in advance-phone 259•8810. . <br /> 2.All work shall be pedormeo in accordance wilh ihis permit and current City ol Everell Design and Construction � <br /> Stantlards and Specilication5. <br /> �I ,_�`' 3.Cell Localion Underground Service 4B hrs.before yoa dig.TOLL FREE NUMBER 1•800•424•5555. <br /> ` � <br /> `�• I�Avc p2� v���in-�C �izoM EI�C or' P�-lv�NlENr <br /> i1��� 1 N iZIC� �I—��—\YAY � ��o=�=1ZT�{ LiN� O <br /> `� - 1 l E-�k{-�'L� NC- Ix�•iirJSt-`aU i 5 -j� � <br /> �'TrbM e F s�o�, � <br /> �, -- Cp . E�zos�otJ coN--rt�oL. As D� ��cr� 8�" �o/ iNSK�ror2. � <br /> ,- a <br /> __ <br /> �^\,�/�G ACKNOWLEDGEME�'T OF CONDITIONS <br /> ��t � -J' � ihe undersiyned owner/applicant hcreby a9rees to hola antl save harnr <br /> � Iess Ihe City ol Everett Irom any and all claims lor damages. co;ts. <br /> expenses, or causes 01 aclion that may anse Uecause ol installation <br /> (����11�� �r-ZI��I antl maintenance ol ihe improvemeN or other right�oi�way usc hcrolo <br /> Appoven�or t,onstfuc�ion applied for and luriher aflrees to remove same upon nolice Imm Ih� <br /> � Da�e Cily and lo replace public property d,maged thereby. <br /> �./�.'!.7-��. � "/u ' % '. /, V�1 1 -y.r . <br /> RNALINSPeCTION Date ^�'�w �v � ��-J"� /- 2�- -`�` <br /> Approved as Cons�ructed Si�nalure ol AnP�icnnl pa�� <br /> ��_�� PUBLICWOPKSOEPARTMENT �h'ORK AUTHORIZED BV THIS PEfiM1T MUST BE STARTED WITHIN <br /> '� 3200CetlarStreel 1i30 DAYS OF DATE PERMIT IS ISSUED AND THEREAFTEP IS TO <br /> Evcr�lt,\NA 9B201 BE DILI�iENTLY PURSUED TO COMPL[TION. THIS PERMIT MAY BE <br /> Phonc:259�eeID CANCELLED BV THE CITV UPON ANY STOPPAGE OF IVORK ON THIS <br /> PROJECT OVER 90 DAYS DURATION. <br />