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y <br /> Date / � �„�,�,�.w�,w.��,m�. =C`�l'.'.��Z <br /> HI�B DCpI • <br /> l��)u�IC�l�1(`fl F(�1 <br /> PUBLIC WORKS PERMIT "°°,�„��'�° s_ - <br /> tcas Ann� 1¢,•Pnm S—�-n� <br /> awi.,��:�u�� s <br /> a�- = <br /> PriM or Type Only <br /> P,/lf � ESTEP /.�3/& R�tC�(Ek E(/,EKt7T 9k2o/ 2 52- `f q28 <br /> Ownei Mai��ng Address C�ty 7_ip Phone <br /> s A�aa,E �s At.3o vE _ <br /> qpplir,ant Ma�ImgAAdress Ctly Zip P!• ��.c <br /> Descr�be Proposed lvcrk gk/� p A�o�/c�E��� 8u'�kH�A� N��T TO S/GE(�tJ/Q�k <br /> ev�n.rn /3!V 6AcK `/eARO , wA� w'ot��E lA"A-T oN6���/A �i " N/G// <br /> A-T rN E oTNF K — <br /> Prolect Address lil knownl �3� �uC.�F� � V� �vERET( �W ry� �7 SzD � <br /> � <br /> Attach lour 14)copies ol P�ans for proposed wo�k � Draw to sw�e an0 note Ihe�o�lo�:�inG as applica6le: � <br /> • Property Lmes • Cemerlir.e ol street � <br /> • Outlme and tllmensions of all e�isfing and • Indlcat� Norih <br /> proposetl struclures on Ihe bt • Show any proposed grading changes <br /> • E.isting and proposed W�Idies • Show measuremenis � <br /> DO NO?WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS <br /> 1.All calis for inspection shall be made 24 hrs.in advance•phone 259-8810. � <br /> 2.All work shall be pedormed in eccordance with this permit and current Ciry of Everett Design and Construction <br /> Standards and SpeCifications. <br /> 3.Call Location Underyround Service 48 hrs.before you dig.TOLL FREE NUMBER 1•800�4Z4•5555. � <br /> O <br /> � <br /> � <br /> ��y!i::'39 ;;:=14Pr COOAN'1F24 � <br /> / <br /> �i000�57E1 <br /> C�i.'0 3'U.OJ <br /> CaSH 2�0.�0 <br /> I�I� ACKNOWLEDGEMENT OF CONDITIONS <br /> �— The undersigned owner/applicaM hereUy agrees to hold and save harm- <br /> Iless Ihe Ciry ot Everetl Irom any and all claims for damages. costa. <br /> eapenses. or ca�ises of action that may arise because of installation <br /> j ' L7 � �.� l,�y and maintenance of the improvement or other right-ol-�vay use hereto <br /> � ,(Q � .U7(`L�'-z� � 7 / ;�pplled for and luriher agrees lo remove seme upon notice Irom the <br /> Approved lor Consiru ion j� Dale City anA to replace pub6c propertY damaged Ihereby. <br /> / <br /> �, o �" ,� �o •Q " � �-/'8q <br /> FI L IN �CTION Da e �K'�'� <br /> ApproveA as Const�uctee Signalwe ol pllcan� Date <br /> WORK AUTIi RIZED BY THIS PE MIT MUST EE STARTED WITHIN <br /> e�P���� PUBLICLVORKSDEPARTMENT 190 DAYS OF DATE PERMIT IS ISSUED AND THEREAFT[R IS TO <br /> � 3200 Cedar Street BE DILIG[NTLY PURSUED TO C0�IPLETION.THIS PERMIT MAY BE <br /> Everett,K'A 9R201 CANCELLFD BY THE CITY UPON ANY STOPPAGE OF WORK ON THIS <br /> Phone:259�E810 PROJECT OVER 90 DAVS DURATION. <br />