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- , , ,:.-.,,,. , . _ <br /> Date <br /> . . .:...: n,;:• • --- --- --- -.. . -- -- <br /> qpphcolion for <br /> PUBLIC WORKS PERMIT °°°ro,';�e�"a 5 — <br /> tess Ro��Fee Pa�a S� <br /> Baiance0ue � � <br /> Print or Type Only <br /> H �� �'�jc C_�� <br /> ��, �t � ��-V� � --�� <br /> A � y �� ���—�Gt-� �p03 `Li�`�lc! �. �.(L�'L'� � � _��-�C - <br /> x <br /> � y� Owner MeJin9 Atldress Cny Zm �honr <br /> � '�C <br /> H y '.� <br /> HZH _.___—_—_— _.. _._—___,—_—_ _— �>r�un�, <br /> K y� qpphcnnt Mailin9 ntlAic'_:s Cily o <br /> � a�H ���LlC�` �xl"��T-tl��' ����1 \� \L " �L�t�.� � <br /> y � Desonba PioPosed Worh <br /> � o �r��cy � t—: � �r � c�� ��-r -��'� f�►2�r�.��;i� <br /> ��g ���,���,��'7- cv,.�c���' c.� �t\���Rc. <br /> �� � c�����'-�`�� - LLf <br /> z H � c �pt`�� — --- — � <br /> a y Proiccl AdAress I�I known) �' " '��' <br /> t" z <br /> H H qttach four�4)coples ol plans lor pmposed w�or�� D�aw to scale and noto ihe following as ap„hczbw � <br /> g � H • Pr�perty Lines • Centerline ol stiu�.a /�^ <br /> O �7 N • Ouihne and dimensions ol all exis�my anA • IndicatC North V� <br /> Q$ prOposed strUG�ures on thC lot • Show any proPo;eii g�a�fing changes <br /> []x � [�zJ • Exis�ing :md proposed uhLhes • Show measuremcnls M <br /> y � � DO NOT WRITE BfLOW Tl115 LINE � <br /> . PE(iMITCONDITIONS O <br /> 1.All calls for inspection shall be made 24 hrs.m advance�phone 259•8810 ^ <br /> 2 NI work shall be pedormed in accortlance wilh this permii and c.unent City of Everett Desi9n and Consiruclion ♦ <br /> � SlandmAs and Specitications. <br /> 3.Cali Loco�ion Underground Service 4B hrs `elom yo�:tlin.TOLL FREE NUM6ER 1•$00-4.�4•5555. � <br /> � <br /> � O <br /> j ��� ;"�L� �/7 ��J ` � <br /> �-- /P�Ub�°e�i �/� <br /> �P�� � _ ..� <br /> i���e � � 0 <br /> �c���a� , �� � f151�� a <br /> �.�� � �f� u P,,..n�' <br /> //�� U nrioras <br /> /��(// ����� �ol�oltlnndsa��,l��arm- <br /> ' 's1 —,_ '_ -- .—_ _. __.__."__ .. :�7�/ .Y,. ' S (or dainaclm> cos�s. <br /> \ �V l� \J <br /> � � era�isu of mstallnbon <br /> . qhPe6waY ��se he�r_In <br /> � _ . ._____-_ - - �, „u�nica wr antl luriher agrees to remove same unon noticc hom mc <br /> . .pir,eed lor Consliur.bon ��110 Cdy and to replaCe public pmperty damaged ihereby- <br /> t iI�AL INSPECTION Datc — <br /> i•.� uwvetl as ConSirucled SignaWre ol App�icant ����' <br /> � PUBLICWORKSDEPARTMENT N'ORK AUTHORI2ED BY THIS PERtdIT MUST 8E STAR7E0 WIIHIN <br /> � 180 DAYS OF DATE PERIdIT IS ISSUED AND THEREAFTER IS TO <br /> �,� 3200GetlarSireet BE DILIGENTLY PUNSueu 'n C01.1PLETION. THIS PERh9T t.1AY �L <br /> ^�.Y � !:.rmt6 WA 90201 CANCELLED BV THE CITY UPOI�ANY STOPPFG[OF 1"JORK ON THIS <br /> P•wnr.259�8610 PROJECT OVER 90 D��S DURN1�OIJ. <br />