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� <br />� <br />TYPE OR PRINT ONLY <br />,�wr.can F« <br />PUBLIC WORKS PER�iAIT <br />�,a� W� ��� <br />3200 Csder SNeM <br />Everett. WA 98201 259•8810 <br />viSiN <br />o.re S/ao/i � '� <br />����. <br />BuNOkp Pwmlt N <br />�,�F�: ZO�_ <br />,,..,�. ..._.....e. -- - , <br />�y �� � �y�y <br />s��E <br />qpp�� Mailing Addrass CkY Z�P �1° '� <br />� <br />PROJECT ADDRESS ('rf known) 4930 - <br />Attach four (!) copim of plans for proposed worlc - Drew to scale and rate tM folbwing H applbable: <br />1+roperty Lines �putline and dNnensbns M all eaisting and proposed atnictures on Me bt �F�cisting end proposed utllHba <br />'CantMine of street 'IMicde Nath 5how any proposed gradirp chengea 5how meesuranxnts <br />PERMIT CONDITIONS: <br />1. All calls for inspection shall be made 24 hours in advance - phone 259-8810. <br />2. All work shall be performed In accordance with this pertnR and current City of Everett Design and <br />Construction Standards and Specifications. <br />3. Call Locatio� Underground Service 48 hrs. before you dig. TOLL FREE NUMBER 1-e00-424-6666. <br />�La <br />W <br />� <br />� <br />� <br />� <br />O <br />a <br />�.;�s�-� _�,00 <br />ACKNOWLEDOEMENT OF CONDITION3 <br />The undera�Bned owner/aPPM� ��Y � to hdd and save hermbae <br />tha CMy of EverMt fiom eny and ell eMkns fa drnspb, cosh, axpeross, a <br />eausea oi actio� Mat may aAas heceuae of Inst�ietbn and mdnle'ww'e oi <br />Me impovement a other rqMo1•way uee hweto eppled lor end hr�hsrepso <br />to ramove eame W�^ raHce hom Me Cky erd to repleca P�dk P�PMY <br />dgmaped therebY• <br />,(�Z,.�-s��.f! Sf� 7/78 <br />s��,,,�w,�,,, �— — ,� <br />WOFK AUTHORIZED BY THIS PERMIT MUST BE STARTED N7THIN 180 DAVS (� DATE PERAIIT IS ISSUED AND T}1EREAFIEA IS TO BE DILKiENTLY PUR9UE� TO <br />CAMPLETION. 7HIS PERMR AAAY BE CANCELLED BY 1HE CI7Y UPON ANY STOPPACaE OF WOFiK ON TTMS PF�ECT OVER 90 OAVS a1MT10N• <br />