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C 27 91 �i.n , �.v� .:r.��..,. - --- — <br /> Cat�J�— ' 31�y��?t� <br /> Bing Deo� � � <br /> APPlication For _. . . <br /> PUBLIC WORKS PERMIT °°"'„'"°,""` - <br /> ,��.�F�� s <br /> �3 O H ���s nnm ccr Pw��� 5 _;,� <br /> � b7 � r, ..-_.i,_.. 5 _ <br /> p � x Print or Type Only <br /> C H <br /> AH (n <br /> , <br /> �3 H John St, dohn 5130 View Dr. Everett 98203 259-5392 .. <br /> K y � Mading Address C�ty Zip �'���'�'�' <br /> Owner <br /> '� �"+ '� Cwner — — <br /> [A H <br /> �7 — Mailin9Addi� Ciiy ZiP Phonc <br /> � � � Applican� <br /> p N d Construct garage/storage <br /> H � �y Descnbe P�oposed Work <br /> O <br /> G]• C] <br /> � " � - W <br /> yz <br /> HH <br /> � y 5130 View Dr. � <br /> rj y Pwject Address li�known) — — <br /> �q �� <br /> h7 � ,:.liach iom�4�copie,ol p�ens lor proposeJ worh� Dr:nv lo scale and note Ihe lollowing as app�ica6le: � <br /> y y • Property Lines • Centeiline of street <br /> H O iA • Oulline and dimensions ol all existmg and • Indir.alr Norih <br /> pwposed st�ucWres on the'o� • Show any,rouused c�radiny chany�rs <br /> � • E�istin9 and ProPosed utilities • Shaw me:,si�r�men�s � <br /> a DO NOT WRITE 8[IAIV'HIS LIN[ O <br /> � F[RMIT CONDITIONS <br /> � �� 1.���calls for inspection sh211 be made 24 hrs.in advan6e-p��C'��259•8810. � <br /> ` 7.�111 werk shall be pedormed in accordance with lhi,Fermil and curruui Gn�ui y+erett Design nnC Cons�ruc�ion <br /> o Standards and Specihcations. <br /> 3.Call Lucalion Undc�9round Scrvicc dF nrs.hclorr yo�dig.TOLL FRE[NUMBER 1•800•424•5555. � <br /> ., ��, O <br /> o-- <br /> H- <br /> _, t� <br /> O <br /> __ a. <br /> � <br /> ; _ <br /> �' - ' <br /> �_ '.\i11' ACKNOIVL[DGfkPdENTOFCOND�TIJNS <br /> �� <br /> ,y The undcrsi9ned owneUnpplicant hereUy a��ees lc hnld antl save hmm- <br /> � less Ihe Gity ol Everett Irom any and all Ualms ior damages. ro�:t:. <br /> ezpenses, or causes ot action ihat m..y arise because ol installahon <br /> _�� 7 [ and maintenance ol Ihe improve t or alher right�of-waY��se heiolo <br /> ,j��j�,�/^✓ -S � epplicd for nnd lurlher agrees r move same upan noLcc hom �h�� <br /> l..� c � �.���I ic,Constructlo Daie Clty entl lo replace puMlc pro t dama d th. � <br /> �C ..��� �-� s�_�/ �L <br /> _/ Date -',�" ,� � / _S! <br /> FINAL INSPECTION S���ature ol AppliCanl ''��' <br /> Approved as ConslructeA <br /> VJnqv nUTHORIZED BV THIS PERMIT MUST BE STA ED ITHIN <br /> �� PUBLICWORKSDEPARTMENt 180 DAYS OF DATE PEf7M1T IS ISSUED AND THEFEAFTER IS TO <br /> 3200 Cedar St�eet 3E DILIGENTLV PU�aSU@D TO C01.1PLETION. THIS PERMIi MAV Lfl <br /> ��% t_vcrrtt\NA'N201 CANCLLIED6YTH[CIIYUPONAIJYSTOPPAGFOFP�ORKONIHIS <br /> (-s,.��c�.�,�+-ra�tG PROJECT OV[R 90 DAYS DUG7Al ION. <br />