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Date�����t� I � �,�:•.,..,�,..� ,. <br /> �,�:,, �,.,, . _�9/a�S6 d <br /> �PPhrniicn f`a _ "'_ __"'—__—_.__ <br /> PUBLIC WORKS PERMIT "°°"°"'°,`"°° <br /> ��,�.,�.,.� s_ <br /> lcaAnn� P.rPn�o 5 <br /> eaia�,..o��e 5_ <br /> PnM or Type Only <br /> �.J.,�t n An d r.s� °����.�� ��'��r� 9��� �sz -�o�z <br /> Ownr,r <br /> Madmg AdO�ess City 7_ip Phone <br /> —"�'�— Mailing Addirss �'' ZiP Phone <br /> ApPhcanl <br /> Descnbc Preposed V/ork -s.rS.�G2.C�1�--+t-�----� <br /> W <br /> Prolett Aadress Id knawnl ��—"-�—pf+��"�— --- � <br /> � <br /> q��a�h�our I41�opi05 0�PIBns lo� P�opOsed worh- Draw lo scale and noie Ih�following as app�ic:ible�. � <br /> i Property Lines • Crnterhne o�streel <br /> • Outline and a:mensio�s ol a�l csistinq and • Ind�cate North <br /> pruposed structwes on Ihc lot • Show ai�y p�oposed grading chanyes <br /> • EA�Shny and proposed utihtie5 • Show measurements M <br /> W <br /> DO NOT WRITE BFIOW THIS LWE O <br /> PERMIT COND�TIONS � <br /> 1.AII calls for inspection shall be made 24 hrs.in advance-phone 2$9•88�0. <br /> 2.All work shall be pedormed in accordance wi�h ihis permit and current Ciry of Everett Design and Consiruction <br /> Standards and Specilications. � <br /> 3.Call Location Underground Servicc 4B hr�.before yoa dig.TOLL FREE NUMBER 1•800•424•5555. <br /> O <br /> � � �i . <br /> ��,(_w.-��Ctc' �C7"-�!/-�, �.�.;.�iir... 1 . �:9' .�.�/ " ��:.-d� � <br /> / � L <br /> '�1/ i���pJ�l'�- � <br /> _'- j' _ `1'� <br /> a <br /> qCKNOWLEDG[hSENT O�COIJDITIONS <br /> 1hu uro�e�signed owner/apPlicant hereby ag�ees lo hold and save herm- <br /> ------- less th� C�ry ot Everelt ��om any and all claims for damayes. costs. <br /> CapenSes. or c.luses 0� edion ihal mly afi5e beC0u5e ot ins�alla��on <br /> and mamtenance o� �he improvemen� or other nghbol-waY ��s� hereio <br /> nppfied �or and luriher agrres to remove same upon notir.e iwm the <br /> Approved�or Construction ��a�� Gty anC to replac� public p�operty damaged Ihereby <br /> FINAI INSPECTION Dalc Date <br /> Approved as Consiructed <br /> Si9nature of ApplicaN <br /> WORK AUTHJFIZED AY THIS PERMIT MUST EE STARTED WITHIN <br /> ��„�i,�� PUBLICWORKSDEPARTMENT 180 DAYS OF UATE PER�dIT IS ISSUED ANL� THEREAFTEF IS TO <br /> � 3200CedarStreel BE DILIG�NTLY PLRSUED TO COMPLE710�L THIS PERh11T MAY BE <br /> EveretL Wn 9920t CANCELLED BY THC CITY UPON ANY STOPPAGE OF VJORK ON THIS <br /> phone 259-8810 PROJECT OVER 90 OAYS DURATION. <br />