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�` • .�"\�.����.�1� .'T " �. �. ' . \� . <br /> (� Sc.� �- f�, t'/��., -1i�,� � y/� <br /> 4-��-8D� .. .. I � `� � I voelm\'Io.��Pnrm,l• �I —�SZ <br /> � Date + � , , Z-/ f-Ji <br /> I • . Aop{iCaUon For , � 9mo oem.• <br /> i PUBLIC W(�RKS PERMIT '°°°°"'°"„°. <br /> � <br /> To�.�F�e s <br /> � O LessAo01 fee 0��4 S <br /> 1 � �( <br /> ^ � � Baunce Dve S �7—Z <br /> Print or Type Only — ;� <br /> `a <br /> ..� .« w <br /> � cl�: ,�oss nC3ns b Assoc. 1001 4th .,ve. , Stz 29�0 Seattle, 'A� d8154- <br /> H S Y Iovest�ent Co. � 1106 <br /> Owner JTANin�.4�dress Ciry Zip Phone <br /> , — — . r� <br /> �— 'J <br /> H 3 Y Invest�ent Co. cr'� :b�s-�t�ms 3 �,ss�c. '.J1 1�h ave. , Sta 29CC Se=t�le, t•!A 4815� <br /> i Applicant htailing Atldress Cdv Lp Phone � <br /> Descnbe P�oposed Work Parkina �OL <br /> 3_� � LL <br /> ProIedA00resslilknow�l ���'}' ''�UC�<8P r�V?flll�, CVeP°=� � <br /> Attach tour�al cop�es ol plans lor pr000sed lvork• Draw to scale and note the lollowing as aophcable: � <br /> • Pwperry Lines • Centerline ol 5treet � <br /> • Outline and dimensions of ali e.�simg and • Intl�cate Norih � <br /> proposea siructures on ihe Io: • Show any prJposed gratling changes <br /> • Fvstmg and proposed uti6ties • Show measurements � <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS <br /> 1.All cells for inspection shall be made 24 hrs.in advance•phone 259•8810. ! <br /> 2.All work shall be pertormetl in accordance with this oarmit and current City ot Everett Design and Constructlon � <br /> Standarda end Specifiwtions. <br /> 3.Call Location Underground Service 48 hrs.before you dig.TOLL FREE NUMBER 1•800-424-5555. � <br /> � `LC.� Cl�7Z� .fJ� OO7u'u �Fi2 ;s��G-207/`c.a�/ L✓�✓ � <br /> 7 / <br /> ,r2�w� c��^� s—s1—�9, <br /> r <br /> ---_ // <br /> � !�/r� �C,C�i��iT iS To r w�� <br /> C,�� <"xi rivKc J �0.2 A.V � <br /> HT.✓J�.iO�J�G lo /f�/OR/Ty.$ �G"'�� ;. <br /> � a <br /> I T��s �Ar����E ir ExPi,�eF" �-�� � <br /> � � <br /> _�^'��e� ; <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The unaersigned owner/appliwnl hereby agrees to hold anC save harrr <br /> ,; less the City of 'cverett Irom any and all claims br tlamages, co51: <br /> exoenses, or causes of action Ihat may anse bocause of installalio <br /> � � .r/�, G,� and mamiena�te of ihe ���p�ovement or other righl-obway use heret <br /> ���-'� appGetl �or antl �uriher agrees to remove same upon notice Irom th <br /> Aooroved tor C7nstructi Date ���yynd to�eplace public properry Oamaged�Mereby. <br /> // -� <br /> , �- . ._ ,..%� � � � {.�� , � r :.�iL'�+^-J��—_ <br /> � / ����� <br /> !� ��'-.L,'�SJ ��` 1 ;,_:;q <br /> FINAL INSFECTION Uate Date <br /> Aoprove0 as Constructed Sionature of Applicant <br /> WOf7K AUTHOR12E0 BY THIS PERMIT MUST BE STAFTED WITHI� <br /> everett PUBLICWQ7KSOEPARTMENT 1B0 DAYS GF DAl'E PERMIT IS ISSUED AND THEREAFTEF IS T� <br /> � 3200Cedar5lreet BE DIIIGENTLY PURSUED TO COMPLETION. THIS PERMIT MAV Bf <br /> Everett.WA 96201 CANCELLED BV THE CITY UPON ANY STOPPAGE OF WORK ON THI: <br /> Phone:259�98t0 PAOJECT OVER 90 DAVS DURATION. <br />