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Jate.��'i«'� _ � ��; [J -� a:mi�cwmesve,mn. .�J��-��7- . <br /> - � <br /> I <br /> v ��nn oeoi • <br /> Aoplica�inn For �c <br /> [- <br /> � PUBUC WORKS �ERMIT '��°;;;,;«eF°� 5 — <br /> a <br /> � � �ess AI�Oi Fne Pai! S� <br /> � :�-, � ir5 eTi,���.,o�0 5 ��9 �� <br /> Print or Type Only . . <br /> m visrn <br /> ra �: mo <br /> .n +,� — <br /> N a <br /> � <br /> �D �D P li !��/i'J �G�`��v�� `J ,�D �, 3 3 Z-,Z�� <br /> wnei \"�v�iin�: 1rUrv.� p. W C�Iq !in Phr,nc <br /> Q� OfY -�a U <br /> -+ o � � w <br /> � 0 3 � s � <br /> /���v��_����a--��.�o����_`��-�t�.__����3 ��3�-7�:_�z� <br /> PPIiCant h" :din:; Atldn�ss Cdy ��P Phuno <br /> Describe Propo,eA Work _��C�L,.��X��--.l:,�u�-��F- -- --- � - - - -- --- ---- -� <br /> _— . . _ ..- ._ . — <br /> ___.—.___ __.. ___ .-_ ___ _ ._-_._. _____.—/'� � <br /> Prolect Address UI known` �.�p�.� ���___a•!�-_.-;/_C_•- __ � <br /> AltaGh lour 141 coP�es ol Plans fa ProPosed wo��. � D�ov: to�e,�b. .�na nnte thn ipilu��vinq as aoGh�ab�e �� <br /> • PropertY Lines • Cen�erline nt s:reet � <br /> • Outline ond Aimensions of all exiSN�q and • Intlir.al�t Narih <br /> P�oPOsetl sUucWres on Ihe lot • �hov: eny crcposorl yPahmn chan�rs <br /> • Erisiino and proposed utilities • Shnw mrasur�mrn�9 � <br /> DO NOT WRIIE 6[LON' 1H15 LINE O <br /> i <br /> • � PERMITCONDITIONS <br /> 1 1.All calls for inspection shall be made 24 hrs.in advance-phone?.59•8a10. � <br /> t 2.All work shall be pedormed in accordance with this permit and r.urreM City of Everelt Design and Cons�ruclion <br /> Standards and Specifications. <br /> 3.Call�ocation Underground Service 48 hrs.bebre you dig.TOLL FREE NUMBER 1-800•424•$555. � <br /> 7: �cY�,� �v h� C✓vn.c�r ���or a,�j�ro✓i C!� O <br /> oh 9/is py c�������!J � <br /> .� /��P�,�a ,�� fo c�icc� c�.� �rc ��of, V+ <br /> �"G9tr��'�S 4n�/ ft/�/�- 4fpUh d , O <br /> ✓ �� � a <br /> l�CKNO�'JLECGCPdENi OF CONDITIONS <br /> �.�� .�.d�.i��,-nvd ownm/apphr.ant herebY agree.5 io hold am1 srn�e hainr <br /> ---- - - -- n�:,s th�- Cdy o� Everett Irom 2ny and ali claims for d.am;�gc:,. ;�.osis <br /> / ' e.penses. o� causes o1 action that may ari5e because ol msinllnfior <br /> �� /�/�� - O�^/ I ,3nq maintenanr.e o! ihe nnProvement or other nghPobway uSP. Iv�mlo <br /> %7� � �� f� i a;-p�,n,-; Ipr and luriher aqrees to remove samn upon noilc.e irom Ihc <br /> Appwved lor Gonstruction % ��'" �'!v .,cd tn i��pl,-,ce puU6c property damaged thereby. <br /> I ��� �C��� �—/5- S�i <br /> FINAL INSPECTION ���� I <br /> Approved as Gonstructed i Sie7natwe ol AnPl�card ����' <br /> � \':OP.K �1UTHORIZED BY THI� PERMIT MUST BE STARTED WITHIN <br /> 'vr�� PUBLICWORKSDEPARTMENT I tH0 DAYS OF OATE PE(7A11T IS ISSUED AND THEREAFTER IS TO <br /> 3200CedarStreet �ii BE DILIG[NTL1' PURSl1ED TO COMPL[TION. THIS PER61I7 I.1AV B[ <br /> Everei�,WA98201 fl1NCELLtD Bf THE CITY UFON �NY STOPPAGE OP WOFK OtJ THIS <br /> Phone�259-8810 � pqO.�ECi OVER 90 D��YS DURATION. <br />