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I <br /> � �ication Fa � <br /> PUBLIC WORKS PERMIT od�e <br /> PUBLIC WORKS DEPARTMENT Public Works Permit M _I v/Z �d <br /> 3200 Cedar Street <br /> Evered,WA 98201 259-8810 <br /> Buildiny Permit N <br /> NPE OR PRINT ONLY Public Works Fee$��G <br /> r/ <br /> � -t�Q✓� 'f"1 l��L�� l 5-C� <br /> Owner � Mailing Address Ciry Zip Phone <br /> Applicant MailingAddress CiTy -' Zip Phone <br /> Describe Proposed Work_ �ZaG� f� � � .=1 VU�.�•�Zi��� !,v ,-I'"j , � � �✓ }�� � <br /> �i � ,h �/�' ln G �, i(�+ � � <br /> � <br /> PROJECT ADDRESS(if known) �� l r it � � � <br /> Attach four(4)copies of plans for proposed work� Draw lo scale:ind note the lollowing if applicable: � I <br /> •Property Lines 'Outline and dimensions of all existing anrl proposed struclures on ihe!ot •Existing and pmposed utilities O <br /> `Centedine of streat •Indicate Nortii •Show any pruposed grading changes •Show measuremeNs �� <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS: � <br /> 1.All calls for inspection shall be made 24 hours in advance-phone 259-8810. i <br /> 2.All work shall be performed in accorciance with this permit and current City of Everett Design and O <br /> Construction Standards and Specifications. � <br /> 3. Call Location Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-800-424-5555. � j <br /> `1 � IVU �� � � �j'OT�ES iv 1 � i <br /> ` j �-� � !il c'+ �ICI� . .. i �.'.,-�Y:t` �(��T �n .. <br /> J J O ' <br /> - , �I-�� ; z o., -I�, I f v I J�r-L;�, � . �� <br /> � , a <br /> , ��oC �,J ; i�-lo.r� -�l �,i,, � f"�� 1� � -� r"< <�G-L ' .- �:,� <br /> � <br /> Y �`�'I v �r� j.i j���� ��`.��-G �7U w ,� �. <br /> �� <br /> j <br /> , <br /> I <br /> i <br /> ? The undersigned ownedapp�canE erebT OF CONDITIONS i <br /> �' y agrees to hold and save hartnless <br /> ;'��(.�-�_�` `�l'� l"�(� 7/ ti(� 6�� tha City o(�eren hom eny and all claims fw damaqes,costs,expenses,or � <br /> Approved for Construchon Oate ceuses 6f actiory�hal may arise because of installation and maintenance of �; <br /> 1h�imprbvembrforotherright-of-wayuseheretoappiiedforand{urth�yagreqs �. <br /> to remd0e s�me upon notice hom the City and to replace public property <br /> dtmagedrt I�reby. <br /> FINAL INSPECTION Uate �� { <br /> \ Approved as Constructed % �� / �✓"1 <br /> �t= ,�C"" � � -- <br /> Signat'ute.dApplicent Date `�, <br /> �UTHORIZED BY THIS PERMIT MUST BE STARTED WIiHIN 180 DAYS OF�ATE PCqMR IS ISSUED AND THEREAF7ER IS TO BE DILIGENTLY PURSUED TO ! ' <br /> jhON.THIS PERMIT MAY BE CANCELLED BY THE Cltt UPON ANY STOPPAGE OF WORK ON 7HIS PRQIECT OVER 90 Q4Y5 DURqT10N. I <br />