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H <br /> M , <br /> -}^YV:�•• M�RI� <br /> } �r, <br /> '���� , . � <br /> � �� <br /> � ��� . ' ^SP� ;x��....' ky. "�' '.. .. . . . ' .�f' .:.�ryy-,.. <br /> / ���� � �Date�J� . Puel¢WnrFs P�I� . � �� <br /> ,,��� p� /1/IICC)l <br /> !, Applicalion For emo oeai • (/J-!1��� � <br /> �� PUBLIC WORKS PERMIT °°°��°w°��°°,e = <br /> iolai Fee <br /> • TO POSTING """°"`°"'"'° ' <br /> �1� r - � i "`7 L Baiance Oue S�Q� <br /> y Print or Type Only , <br /> t� <br /> ��0 �� L. 1 �' �1 n f �) DX �'7Q� �–V7' Q�S�� `��J` 9'2�'h _ <br /> �r [. Owner MalNng Address C�ty Lp Phone <br /> 6 tA � _ <br /> . Applieent MailingAddress City Zip Phc�e ' <br /> Uescribe Proposed Work •' �Q��J l�mS� `'1 (1 n'11� Q� _ � <br /> .. . r. <br /> 4 � ` � <br /> � Proiect nedress 1�1 known) �92� '—.l.S1�c� A^�- �9 , � I <br /> Altach four(4)cop�es of plens lor proPosed work- Dra���to scale and note ihe following as applictble: PLN CN f180.�2 � I <br /> • Pmperry�ines • Centedine o�street 8 $RCH f10.50 //\ i <br /> •Outline and dimensions ol all e.isting and • Indicate North ��f �,� ��� <br /> F p.oposetl strw'ures un Ihe lol • Show any proposed gradi�� <br /> • Ex�stin9 and proposed utilitles • Show measurements �� f�,� I�A <br /> yv� � DO NOT WRITE BELOW THIS LINE ' � ��. � <br /> 1 ! M0000'ros7 O I <br /> � � PERMITCONDITIONS W1TER 1750.� <br /> C� 1.All calls lor inspection shall be mede 24 hrs in advance-phone 259•6810. ry�(� � �,� i <br /> r.� J � 2.All work shall ba pedormed in eccordance with this permit antl current City ol Everetl Design e-'�d Cons�mc�ion � <br /> � StendardsandSpecifications � <br /> � ' 3.Call Locetion Underground Service 40 hrs.6elore you dig.TOLL FREE NUMBER 1•800•424•5555. � ; <br /> � ��' `� �i�zu (Y3��(p'.rv dt o�a.ina�Ld .Sea�.e..�.�.� o.Oc+r�q �uc/l...ciuQ,esu. O I <br /> S/�i�� �� aa dciu.�a� � .'c�`� Cc.�y i <br /> O <br /> �.� �ul:.C'�a cvdzlea, ,t�'+a�a-p,e.Z`ov - �— <br /> ��� S .�i-o��,QEu�az .s�Q�( be ,�r,n��aF�uO�d'�, � .Ct`t(:-nd'o/�/ .�60� ¢ 6G� ♦A i <br /> . .. (D. �n�"%_ cYOZ`PtS/04'i� `�Ia.Q�� CG�27u=f� -�C� SC0.'CI SCK�Y�Y. V� � <br /> i .—w1 7 /�rn.eny �2tc�c:I� .eva .�ifu/ Q.CC'�.�1 7nua-7�.1u �U/L d-rd�u+�n4 '�3//a O ,. <br /> I L �, o a � <br /> i I <br /> V �'� ACKNOWLEDGEIv1ENTOFCONDITIONS I <br /> \ Th�undersi9ned owner/applicant heieBy agrees to holtl an cvm� <br /> — - - ie.= the City ol Everelt from any and all claims lor dar. .; , r.o,�s. � <br /> n G / repenses, or causes ol action Ihat may arise because '.stallation <br /> � / y{� ,._.�= ��,aO and maintenance of ihe improvement ar other ri�hl-ol-w�y �sc he.reto <br /> fCJ tr7u���_- � <br /> applicd br and lunher agrees to rcmove same upon notice Irom ihe <br /> Approved lor Construction O��e City anA to eplace puUlic p�aPer�y dama9ed ihereby. i <br /> ,.� � n � <br /> �i'� .i� !'C- _�-- /—/�. - S Z /� � <br /> FINAL INSPECTION Date ' <br /> qpproved as Constructed igna me of Ap i N �� <br /> WORK AUTHORIZED BY THIS PERMI UST BF STARTED WITHIN � <br /> everett PUBLICWORKSDEPARTMFNT 1D0 DAYS OF DATE PERMIT IS �SS D AND THEREAFTER IS TO <br /> � 3200CedarStreet BE DILIGENTLY PURSUFD TO COIdPLETION.THIS PERMIT MAV Bf_ <br /> Eveietl,WA 96201 CANCELLED BV TH[CITY UP(�N ANV 5 iOPPAGF OF WORK ON THIS <br /> Phonc:259-8810 PROJECT OVEF QO DhVS DU'�F�ION. <br />